Étude des facteurs prédictifs de séquelles à 2 ans en lien avec une infection congénitale à Cytomégalovirus

Abstract : Objectives: cytomegalovirus (CMV) is the leading cause of congenital infection in the world with a major risk of sequelae including neurological and auditory. The aim of the study is to identify what are the prognostic factors for defining neonates at risk of developing sequelae at 2 years related to congenital CMV infection. Design of the study: monocentric retrospective observational study including 220 patients born between January 2001 and October 2015 with congenital CMV infection. We studied various pre- and postnatal factors and their impact on the outcome at 2 years of age for children with congenital CMV infection. Results: the presence of at least one postnatal abnormality (clinical examination or additional investigations) was a risk factor for developing sequelae at 2 years (p = 0.037). Neonates with maternal seroconversion in the first trimester were more likely to develop sequelae at 2 years (p <0.001) than later seroconversion. Hypotrophy, microcephaly, abnormalities of neonatal clinical examination and Cranial ultrasound abnormalities are risk factors for 2-year sequelae from all causes. Discussion: in children strictly asymptomatic at birth, there is no disability at 2 years, but the definition of symptomatic or non-symptomatic infection at birth should be revisited. The risk of sequelae appears restricted to fetal infections during the first trimester of pregnancy. In view of current data, a scheme for the prevention and management of congenital CMV infection may be proposed.
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Master Thesis
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Lucile Petermann. Étude des facteurs prédictifs de séquelles à 2 ans en lien avec une infection congénitale à Cytomégalovirus. Médecine humaine et pathologie. 2018. ⟨dumas-02161358⟩

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