Prognostic Factors of Late-onset Hearing Loss in Infants With Congenital Cytomegalovirus and Normal Audiologic Assessment at Birth.
Por:
Buonsenso D, Pedrero-Tomé R, Raimondi F, Salomé S, Papaevangelou V, Syridou G, Rios-Barnés M, Fortuny-Guasch C, Villaverde S, de Vergas J, Baquero-Artigao F, Rodríguez-Molino P, Frick MA, Álvarez-Vallejo B, Saavedra-Lozano J, Fougere Y, Del Valle R, Ara-Montojo F, Foulon I, Mignogna S, Muga Zuriarrain O, Lyall H, Vives-Oñós I, Colino E, Tsiatsiou O, Moliner E, Garofoli F, Cuadrado I and Blázquez-Gamero D
Publicada:
29 ene 2026
Ahead of Print:
21 ago 2025
Resumen:
BACKGROUND AND AIMS: Children with congenital cytomegalovirus (cCMV) can develop late-onset sensorineural hearing loss (LO-SNHL). In this study, we aim to assess the characteristics and predictors of LO-SNHL in infants with cCMV having normal hearing at the first neonatal assessment. METHODS: A retrospective study within the European Registry of Children with cCMV (www.ccmvnet.org) was performed. Included children had cCMV and a normal first audiological assessment by Auditory Brainstem Response (ABR). Late-onset hearing loss (LO-SNHL) is defined as the presence of sensorineural hearing loss after an initial normal hearing test. Hearing evaluation was performed at birth, at 6 months of age, and at least annually up to 6 years of age. RESULTS: Seven hundred twenty-one children with normal audiological tests at birth were included, and 47/721 (6.5%) developed LO-SNHL. LO-SNHL was diagnosed at a range of 4-65 months of age [median (IQR) age: 34.3 (15.1-48.7) months]. Children with LO-SNHL had a higher proportion of abnormalities on physical examination at birth (45.7% vs. 20.8%; P < 0.001): petechiae (17.4% vs. 6.0%; P = 0.008), splenomegaly (8.7% vs. 2.3%; P = 0.031), hepatomegaly (13% vs. 2.9%; P = 0.001), microcephaly (15.2% vs. 4.5%; P = 0.005) and small for gestational age (21.7% vs. 8.3% P = 0.005). Children with LO-SNHL showed lower platelet count at birth [177500.0 (88750.0-261250.0)/µL vs. 243500.0 (173000.0-304000.0)/µL; P = 0.012], and higher blood viral load at birth [3.7 log (3.3-4.4) vs. 3.4 log (2.7-3.9) IU/mL; P = 0.013] and had more frequent white matter involvement (27.7% vs. 14.7%; P = 0.03) and ventriculomegaly (20.7% vs. 4.6%; P = 0.001) on birth magnetic resonance imaging. Overall, symptomatic children at birth showed a higher risk of developing LO-SNHL than asymptomatic children (32/317, 10.1%, vs. 15/404, 3.7%; P < 0.0001). Among asymptomatic children, only 0.3% developed severe or profound LO-SNHL in the best ear.In multivariate logistic regression analysis, ventriculomegaly [odds ratio (OR): 7.503 (1.78-27.9)], white matter abnormalities [OR: 3.19 (1.010-9.01)], and splenomegaly [OR: 3.679 (1.56-8.506)] at birth were associated with the development of LO-SNHL (Fig. 1). CONCLUSIONS: Among this large cohort of children with cCMV and a first normal audiological assessment, the risk of LO-SNHL was 6.5%. Asymptomatic children developed LO-SNHL in 3.7% of the cases versus 10.1% in symptomatic cases. In multivariate logistic regression analysis, ventriculomegaly, white matter abnormality, and splenomegaly at birth were associated with LO-SNHL.
Filiaciones:
Buonsenso D:
From the Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Area Pediatrica, Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
Pedrero-Tomé R:
Instituto de Investigación Hospital 12 de Octubre (imas12), Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
Raimondi F:
Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
Salomé S:
Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
Papaevangelou V:
Third Department of Pediatrics, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
Syridou G:
Third Department of Pediatrics, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
Rios-Barnés M:
Infectious Diseases Department, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC)
Fortuny-Guasch C:
Infectious Diseases Department, Hospital Sant Joan de Déu and Institut de Recerca Sant Joan de Déu, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC)
Villaverde S:
Instituto de Investigación Hospital 12 de Octubre (imas12), Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
de Vergas J:
Otorhinolaryngology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
Baquero-Artigao F:
Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC)
Rodríguez-Molino P:
Pediatrics, Infectious and Tropical Diseases Department, Hospital Universitario La Paz, Instituto Investigación Hospital La Paz (IDIPaz), Madrid, Spain, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC)
Frick MA:
Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Infantil. Vall d'Hebron Barcelona Hospital Campus. Barcelona, Catalonia, Spain
Álvarez-Vallejo B:
Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Infantil. Vall d'Hebron Barcelona Hospital Campus. Barcelona, Catalonia, Spain
Saavedra-Lozano J:
Pediatric Infectious Diseases Unit, Hospital Universitario Gregorio.Marañón, Universidad Complutense de Madrid. Madrid, Spain, Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)
Fougere Y:
Unit of Pediatric Infectious Diseases and Vaccinology, Department of Woman Mother and Child, Lausanne University Hospital, Lausanne, Switzerland
Del Valle R:
Department of Pediatrics, Hospital Universitario Infanta Sofia, San Sebastián de los Reyes, Spain
Ara-Montojo F:
Hospital Universitario Puerta de Hierro, Spain
Foulon I:
Department of Otolaryngology-Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium and De Poolster, Rehabilitation Centre, Brussels, Belgium
Mignogna S:
Catholic University of Rome, Medical School, Italy
Muga Zuriarrain O:
Department of Pediatrics, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
Lyall H:
Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, and Imperial College, London, UK
Vives-Oñós I:
Department of Pediatrics, Hospital Quironsalud Barcelona, Barcelona, Spain
Colino E:
Department of Pediatrics, Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria, Spain
Tsiatsiou O:
3rd Department of Pediatrics, Aristotle University of Thessaloniki and Hippokration General Hospital, Thessaloniki Greece
Moliner E:
Hospital de la Santa Creu i Sant Pau, Spain
Garofoli F:
SC Neonatologia e Terapia Intensiva Neonatale Fondazione IRCCS Policlinico S. Matteo, Pavia
Cuadrado I:
Hospital Universitario de Getafe
Blázquez-Gamero D:
Instituto de Investigación Hospital 12 de Octubre (imas12), Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
Pediatric Infectious Diseases Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
Universidad Complutense de Madrid, Spain
Noguera-Julian A:
Hospital Sant Joan de Deu
Fortuny-Guasch C:
Hospital Sant Joan de Deu
Rios-Barnés M:
Hospital Sant Joan de Deu
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