Association between Congenital Cytomegalovirus Infection and Brain Injury in Neonates: A Meta-analysis of Cohort Studies
Li Zhang, Zhankui Li, Xiang Han, Hongyan Du, Yingli Cao, Yingmei Liu, Wenfeng Wang
Abstract
Objective. To assess association between congenital cytomegalovirus (CMV) infection and brain injury in neonates. Methods. The literatures from inception to November 4, 2020, were searched through PubMed, Embase, Cochrane Library, and Web of Science. Heterogeneity test was conducted for each indicator and measured by <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"><a:msup><a:mrow><a:mi>I</a:mi></a:mrow><a:mrow><a:mn>2</a:mn></a:mrow></a:msup></a:math> statistics. If <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"><c:msup><c:mrow><c:mi>I</c:mi></c:mrow><c:mrow><c:mn>2</c:mn></c:mrow></c:msup><c:mo>≥</c:mo><c:mn>50</c:mn><c:mi>%</c:mi></c:math> , the random effects model was applied; otherwise, the fixed effects model was used. Sensitivity analysis was performed for all models. Weighed mean difference (WMD) was used as the effect size for measurement data, and risk ratio (RR) was as the effect indicator. Results. A total of 13 studies, including 4,262 congenital CMV infection neonates, were enrolled in this study. Our results showed that the rate of hearing impairment (RR: 2.105, 95% CI: (1.115, 3.971), <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"><e:mi>P</e:mi><e:mo>=</e:mo><e:mn>0.002</e:mn></e:math> ), sensorineural hearing loss (SNHL) (RR: 17.051, 95% CI: (6.201, 46.886), <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"><g:mi>P</g:mi><g:mo><</g:mo><g:mn>0.001</g:mn></g:math> ), and microcephaly (RR: 2.283, 95% CI: (1.325, 3.935), P =0.003) in neonates infected congenital CMV was higher than that in control group. Conclusion. The risks of hearing impairment, SNHL, and microcephaly in neonates during childhood may be associated with congenital CMV infection. It is necessary to establish neonatal screening programs and comprehensive diagnostic tests for patients to reduce the risk of adverse brain damage to the congenital CMV infection as early as possible and to improve the prognosis of the newborn.