SURVEILLANCE FOR CONGENITAL CYTOMEGALOVIRUS DISEASE - A REPORT FROM THE TIONAL-CONGENITAL-CYTOMEGALOVIRUS-DISEASE-REGISTRY

A national surveillance program for congenital cytomegalovirus (CMV) d isease was initiated in 1990. In 4 years 285 cases were reported witho ut seasonal patterns. Mean birth statistics were as follows: gestation al age, 36 weeks; weight, 2,224 g; length, 45 cm; and head circumferen ce, 30 cm. Of the infants 68% had CNS involvement, which was significa ntly (P<.005) associated with a direct bilirubin level of greater than or equal to 3 mg/dL, petechiae, an alanine aminotransferase level of >100 U/L, a platelet count of less than or equal to 75,000/mm(3), hepa tomegaly, and splenomegaly (P<.05). Maternal demographics revealed tha t the mean age was 23 years (range, 13-38 years), 59% were white, 33% were black, 47% had low incomes (receiving Medicaid), and 45% were pri miparous. Compared with 1990 birth statistics in the United States, mo thers of infants with congenital CMV disease were younger, and a great er percentage of these mothers were black. Two distinct maternal group s were identified on the basis of age, socioeconomic status, and parit y. This finding may reflect different modes of transmission and sugges t target populations for future CMV vaccine initiatives.