Congenital CMV

According to the Centers for Disease Control and Prevention (CDC), CMV is the most common congenital (meaning from birth) viral infection in the United States, North America, Western Europe or “developed countries”. 1 in 150 children is born with congenital CMV in the United States. Each year, 30,000 children are born with congenital CMV, causing 400 deaths and leaving 8,000 children with permanent disabilities. More children will have disabilities due to congenital CMV than other well-known infections and syndromes, including Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and Pediatric HIV/AIDS.

Prenatal Signs of Congenital CMV

If one or more of the following signs are identified via ultrasound, an amniocentesis should be done to confirm a congenital CMV infection:

• Placental thickening
• Organomegaly - abnormal enlargement of organs
• Hepatomegaly – abnormal enlargement of the liver
• Splenomegaly – abnormal enlargement of the spleen
• Pyelectasis - dilation of the renal pelvis, the funnel-like dilated proximal part of the ureter (muscular tubes that propel urine from the kidneys to the urinary bladder) in the kidney (also a marker for Down Syndrome)
• Megaloureter – abnormal dilation of the ureter
• Ascites - gastroenterological term for an accumulation of fluid in the peritoneal cavity (is a potential space between the parietal peritoneum and visceral peritoneum, that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall)
• Fetal hydrops - accumulation of fluid in the fetal compartments
• Abnormality of amniotic fluid
• Microcephaly – small head circumference, more than two standard deviations smaller than average
• Cerebral ventriculomegaly – dilation of the lateral ventricles of the brain
• Intracranial calcifications - the build up of calcium salts in the soft tissue of the brain
• Hyperdense image in thalamic arteries
• Periventricular echodensities
• Hepatic echodensities
• Intestinal echodensities
• Cystic structures in the germinal zone

Neonatal Signs of Congenital CMV

A newborn may have congenital CMV if they are showing any of the following signs:

• Thrombocytopenia – low blood platelet levels
• Petechiae (purpura) - Red or purple spots on the body caused by broken blood vessels
• Jaundice - yellow skin and eyes caused by increased bilirubin levels in the blood
• Microcephaly - Small head size
• Small size at birth - IUGR (Intrauterine Growth Restriction)
• Premature birth of unknown etiology
• Liver problems, including Jaundice of unknown etiology
• Spleen problems
• Lung problems
• Bleeding problems
• Growth problems
• Seizures
• Hearing loss
• Vision loss
• Mental disability

(Note: If a newborn does NOT show any of the following signs at birth, it does not mean they cannot be diagnosed with congenital CMV.)

Permanent Health Problems or Disabilities/Long-Term Outcomes

Permanent health problems or disabilities that may occur due to congenital CMV infection:

• Hearing loss
• Vision loss
• Mental disability
• Feeding issues/Failure to Thrive (FTT)
• Sleeping issues
• Sensory issues
• Behavior issues
• Small head/small brain (Microcephaly)
• Intercranial calcifications
• Lack of coordination
• Cerebral palsy
• Seizures
• Death

(Note: If a newborn is diagnosed with congenital CMV, it does not mean that they will necessarily develop the above listed health problems and/or disabilities.)