Congenital cytomegalovirus (CMV) is a condition found in newborns infected with the virus in the womb, with the greatest risk occurring when a mother is infected early in pregnancy. Symptoms can vary, with some children asymptomatic and others with severe manifestations. Treatment focuses on relieving symptoms and using intravenous antiviral drugs. CMV is commonly transmitted through contact with bodily fluids and can lie dormant in the body for years after infection.
Congenital cytomegalovirus (CMV) is a condition found in newborns who were infected with this virus while in the womb. The greatest risk of developing this condition occurs when a mother who has not previously been exposed to this virus becomes infected early in her pregnancy. Although many children are asymptomatic after in utero exposure to CMV, some have severe manifestations, including low blood counts and brain malformations. Treatment of congenital cytomegalovirus infection focuses on treating symptoms and using intravenous antiviral drugs.
Human cytomegalovirus is a pathogen that infects many people around the world. It is commonly transmitted through contact with bodily fluids, including saliva and urine. Once the virus enters the body, it invades cells and replicates within them. The virus can often lie dormant in the human body for years after infection.
Problems can arise when a pregnant woman becomes infected with CMV for the first time. The virus infects the mother, replicates within her cells and sends new virus particles into the mother’s bloodstream. These copies of CMV can cross the placenta and enter the fetal circulation, causing infection in the developing baby. The fetus typically has the worst infection when exposed to CMV early in the development process, especially within the first trimester of pregnancy.
Manifestations of congenital cytomegalovirus infection can vary, with some children asymptomatic and others with severe symptoms. As many as 90% of babies who had evidence of CMV exposure before birth were initially asymptomatic and had no major problems. Some of these children, however, continued to struggle with learning disabilities, mental retardation and hearing loss. These late developing symptoms are often never associated with CMV due to their delayed presentation.
Other babies exposed to CMV in utero are born with severe symptoms of congenital cytomegalovirus. They may have low birth weight, low red blood cell count, jaundice, decreased number of platelets in the blood, and an enlarged liver. Some also have birth defects that alter their physical appearance, including microcephaly or a small head. These children with severe findings often have a poor prognosis and have problems with mental retardation, seizures, and motor development.
Treatment of congenital cytomegalovirus infection typically focuses on relieving symptoms caused by the disease. For example, a baby born with a low red blood cell count might be treated with a blood transfusion. Some researchers have studied the benefits of treating affected newborns with intravenous antiviral drugs and have found that this therapy could help reduce the progression of some symptoms. For mothers who had a CMV infection early in pregnancy that caused severe birth defects evident on prenatal ultrasound, elective abortion is sometimes offered. Treatment with antiviral agents during the course of pregnancy has not been shown to offer any benefit.
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