Elsevier

The Journal of Pediatrics

Volume 200, September 2018, Pages 196-201.e1
The Journal of Pediatrics

Original Articles
Racial and Ethnic Differences in the Prevalence of Congenital Cytomegalovirus Infection

https://doi.org/10.1016/j.jpeds.2018.04.043Get rights and content

Objective

To evaluate the impact of race and ethnicity upon the prevalence and clinical spectrum of congenital cytomegalovirus infection (cCMV).

Study design

From 2007 to 2012, 100 332 infants from 7 medical centers were screened for cCMV while in the hospital. Ethnicity and race were collected and cCMV prevalence rates were calculated.

Results

The overall prevalence of cCMV in the cohort was 4.5 per 1000 live births (95% CI, 4.1-4.9). Black infants had the highest cCMV prevalence (9.5 per 1000 live births; 95% CI, 8.3-11.0), followed by multiracial infants (7.8 per 1000 live births; 95% CI, 4.7-12.0). Significantly lower prevalence rates were observed in non-Hispanic white infants (2.7 per 1000 live births; 95% CI, 2.2-3.3), Hispanic white infants (3.0 per 1000 live births; 95% CI, 2.4-3.6), and Asian infants (1.0 per 1000 live births; 95% CI, 0.3-2.5). After adjusting for socioeconomic status and maternal age, black infants were significantly more likely to have cCMV compared with non-Hispanic white infants (adjusted prevalence OR, 1.9; 95% CI, 1.4-2.5). Hispanic white infants had a slightly lower risk of having cCMV compared with non-Hispanic white infants (adjusted prevalence OR, 0.7; 95% CI, 0.5-1.0). However, no significant differences in symptomatic cCMV (9.6%) and sensorineural hearing loss (7.8%) were observed between the race/ethnic groups.

Conclusions

Significant racial and ethnic differences exist in the prevalence of cCMV, even after adjusting for socioeconomic status and maternal age. Although once infected, the newborn disease and rates of hearing loss in infants are similar with respect to race and ethnicity.

Section snippets

Methods

From March 2007 to March 2012, infants born at 7 US medical centers were enrolled in the CMV and Hearing Multicenter Screening (CHIMES) Study.12 Saliva specimens were collected from the newborn and additional dried blood spots were obtained at the time of newborn metabolic screening and tested for CMV, as previously described.13, 14, 15 Infants with positive saliva or dried blood spots screening specimens were enrolled in the follow-up component of the study within the first 3 to 6 weeks of

Results

Of the 108 925 mothers approached for participation in the CHIMES Study, 100 607 mothers consented and 8318 (7.6%) mothers declined to participate in the study. Adequate enrollment specimens were available for 100 332 of the infants and 497 infants screened positive for CMV. In 391 infants, cCMV was confirmed by a follow-up positive saliva or urine sample using the rapid culture or PCR methods.16 Thirty-five infants were considered uninfected because the follow-up saliva and urine samples were

Discussion

Significant racial and ethnic differences exist in the prevalence of cCMV, although once infected, the clinical manifestations and rates of hearing loss in infants are similar with respect to race and ethnicity. The overall cCMV rate of 4.5 per 1000 live births found in our cohort of more than 100 000 infants is lower than previous reported prevalence rates of 6.4 per 1000 live births and 7 per 1000 live births from 2 meta-analysis studies.2, 3 Most of the data on cCMV prevalence from these

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    Supported by the National Institute on Deafness. Other Communication Disorders (NIDCD) provided grant support for the CHIMES Study (N01 DC50008, HHS-N-263-2012-00010-C). The authors declare no conflicts of interest.

    Portions of this study were presented at the 12th International CMV/BetaHerpesvirus Workshop, May 10-14, 2009, Boston, Massachusetts; the 3rd International Congenital Cytomegalovirus Conference, September 23-25, 2010, Paris, France; the 4th Congenital CMV Conference/14th International CMV/BetaHerpesvirus Workshop, October 29-November 2, 2012, San Francisco, California; and the Pediatric Academic Societies and the Asian Society for Pediatric Research (PAS/ASPR) Joint Meeting, May 3-6, 2014, Vancouver, British Colombia, Canada.

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