Cytomegalovirus (CMV) is the leading cause of congenital infection. Its occurrence is phenotypically heterogeneous. The type of maternal infection, primary or non-primary, is an important factor related to the symptomatic disease, the primary infection was long considered the only cause of severe neonatal disease. We aimed to analyze the association of primary and non-primary infection with pathological outcomes in infants and with long-term sequelae at follow-up. This was a monocentric retrospective observational study on a population of 91 infants diagnosed with a CMV infection at the Neonatal Care Unit of Neonatology at the Sant’Anna Hospital of Turin during the period of June 2005 to December 2018. Infants underwent clinical, laboratory, and neuroradiological evaluations at birth. Subsequently, the patients were monitored in an auxological, neurodevelopment, and audiological follow-up. Regarding primary vs. non-primary infection, we found a higher percentage of incidence of symptomatic and neurological localized infection, as well as long-term sequelae in the latter. However, no significant difference between the two populations was found. We underline the possibility of re-infection in previously immunized mothers (non-primary infection) with unfavorable neonatal and long-term outcomes.

Background: Congenital cytomegalovirus (cCMV) is the most frequent infective cause of morbidity and long-term sequelae in infancy. Despite great attention to this clinical condition, potential prognostic factors for neurodevelopmental sequelae in cCMV patients are poorly understood, therefore hampering optimization of clinical care and management of cCMV patients. Methods: A retrospective single-center cohort study was conducted on 66 infants with congenital CMV infection in order to identify among clinical presentation at birth potential predictors of the absence of neurodevelopmental sequelae at 12 months of age. A logistic regression model was built in order to identify a correlation between potential predictors and neurodevelopmental status at one year of age in the cohort in the study. Results: The results of our study showed a significant correlation between normal neutrophil count and normal audiological assessment at birth in a logistic regression model (p < 0.05) in patients with cCMV with the absence of neurodevelopmental sequelae at M12. Our findings also underlined that normal platelet count and normal cerebral imaging are connected with normal neurodevelopment at one year of age, though not in a statistically significant way. Conclusions: Our findings underscore the need for appropriate assessment at birth in order to improve clinical management of cCMV patients.