10-YEAR CLINICAL, DEVELOPMENTAL, AND INTELLECTUAL FOLLOW-UP OF CHILDREN WITH CONGENITAL CYTOMEGALOVIRUS-INFECTION WITHOUT NEUROLOGIC SYMPTOMS AT ONE-YEAR OF AGE

Objective. This study was undertaken to ascertain whether children wit h congenital cytomegalovirus (CMV) infection at birth, but without neu rologic symptoms at 1 year of age, differed in somatic, neurologic, de velopmental, or intellectual status from matched control children at l ong-term follow-up. Material and Methods. Congenital CMV infection, as demonstrated by isolation of the virus within the first week of life, was diagnosed in 44 (0.5%) of 9806 infants. From this basic CMV-infec ted population, children who developed neurologic disturbances includi ng sensorineural deafness before 1 year of age were excluded (n = 7), as were those unwilling to participate (n = 2). Congenitally infected infants (n = 35) and matched control infants (n = 53) were followed up clinically and neurologically. At 21 months, development was assessed with the Griffiths' Developmental Scale and at 7 years of age neurolo gic status was assessed with the Stott test and intellectual developme nt with the Wechsler Intelligence Scale for Children. Results. As repo rted previously, 18% (8/44) of the CMV-infected infants manifested sym ptoms at birth, as compared to 8% (4/53) in the control group. In the congenital CMV group 7% (2/30) children tested had abnormal Stott test results, as compared to 2% (1/43) in the control group. Thirty-two CM V-infected and 51 control group children were assessed with the Griffi ths' scale at 21 months of age. The two groups did not differ signific antly, either in mean scores (6.3 +/- 2.3 vs 6.1 +/- 1.9) or in the pr oportion of children with scores below normal (19% [6/32] vs 16% [8/51 ]). Twenty-five CMV-infected and 41 control group children were assess ed with the Wechsler Intelligence Scale for Children at 7 years of age (median 86 months; range, 82 to 90 and 82 to 91, respectively). The t wo groups did not differ significantly, either in mean scores (5.8 +/- 2.0 vs 6.4 +/- 1.6) or in the proportion of children with scores belo w normal (12% [3/25] vs 5% [2/41]). Conclusion. Children with congenit al CMV infection are unlikely to be at an increased risk of subsequent neurodevelopmental or intellectual impairment if they show normal dev elopment at 12 months of age.