- Overview of Infections in Newborns
- Sepsis in Newborns
- Hospital-Acquired Infections in Newborns
- Pneumonia in Newborns
- Bacterial Meningitis in Newborns
- Listeriosis in Newborns
- Conjunctivitis in Newborns
- Herpes Simplex Virus (HSV) Infection in Newborns
- Hepatitis B Virus (HBV) Infection in Newborns
- Cytomegalovirus (CMV) Infection in Newborns
- Rubella in Newborns
- Syphilis in Newborns
- Toxoplasmosis in Newborns
- Tuberculosis (TB) in Newborns
Cytomegalovirus is a common virus that usually causes few or no problems but can cause serious illness in infants who are infected before birth or around the time of birth.
Cytomegalovirus infection is caused by a virus.
Most newborns do not have symptoms, but some do depending on when they were infected.
Doctors diagnose the infection by identifying the virus in a sample of urine, saliva, blood, or tissue.
Cytomegalovirus infection cannot be cured, but some antivirals can limit the problems it causes.
Newborns may develop neurologic problems such as hearing loss.
Handwashing can help prevent spread of the virus.
(See also Overview of Infections in Newborns and Cytomegalovirus (CMV) Infection in adults.)
Infection with cytomegalovirus (CMV) is very common. Blood tests show that most adults have had a CMV infection at some time. The virus never goes completely away and remains dormant (inactive) in various tissues for life. Sometimes the virus reactivates (becomes active again).
Most people who have CMV infection, including newborns, do not have any symptoms.
When a baby contracts CMV infection in the uterus, it is called congenital CMV infection. When a baby develops the infection immediately before, during, or shortly after birth, it is called perinatal CMV infection. CMV infection is the most common congenital viral infection.
Pregnant people who have never had CMV infection may acquire it through contact with infected people, most commonly young children. In some pregnant people, a previous CMV infection reactivates. When pregnant people are infected, they can pass the virus to their fetus during pregnancy if the virus crosses the placenta (the organ that provides nourishment to the fetus) and infects the fetus.
Newborns may also become infected during passage through the birth canal, through human milk containing the virus, or through a contaminated blood transfusion.
Preterm infants are at higher risk of developing symptoms from CMV infection because they are less likely to have protective antibodies from their mother.
Symptoms of CMV Infection in Newborns
CMV infection may cause different problems in newborns depending on whether they were infected before or after birth.
Approximately 13% of newborns who are infected with CMV before birth have symptoms.
In newborns infected before birth, possible symptoms include
Low birth weight
Jaundice (yellowing of the skin or whites of the eyes)
Small bruises in the skin
An enlarged liver and spleen
Inflammation of the lungs or eyes
In newborns infected during or after birth, possible symptoms include
An enlarged liver and spleen
A high white blood cell count
Some newborns have all of these symptoms.
Newborns who are infected through human milk (breastfeeding) tend to have a milder infection.
Diagnosis of CMV Infection in Newborns
Polymerase chain reaction (PCR) test using urine, saliva, blood, or tissues
Testing of urine, saliva, or tissue samples
To diagnose CMV infection before birth, doctors take a sample of the amniotic fluid and test it.
To diagnose CMV infection after birth, doctors take samples of the newborn's urine, saliva, or tissues. The samples are sent to a laboratory so the organism causing the infection can be identified.
Doctors also do a PCR test on samples of the newborn's urine, saliva, blood, or tissues. This laboratory technique, which produces many copies of a gene to make the gene easier to detect, can be used to detect the CMV virus in the newborn.
Other tests, such as blood tests, imaging tests of the head, and an examination of the eyes, are done to look for infection and inflammation and to determine the seriousness of the symptoms. Doctors also may test the hearing of infected newborns. This testing is more extensive than the usual newborn hearing screening.
Doctors may evaluate the newborn for other infections present at birth that can cause symptoms similar to CMV, including toxoplasmosis, rubella, syphilis, and herpes simplex virus.
Treatment of CMV Infection in Newborns
Ganciclovir or valganciclovir for newborns who have symptomsGanciclovir or valganciclovir for newborns who have symptoms
There is no cure for CMV infection.
Ganciclovir and valganciclovir are medications that combat viral infections (Ganciclovir and valganciclovir are medications that combat viral infections (antivirals) and may help relieve some symptoms or make the infection less severe.
Infected newborns should have repeated hearing tests during the first year of life.
Prognosis for CMV Infection in Newborns
CMV infection is fatal in 5 to 10% of newborns who have symptoms. Most of the infants who have symptoms who survive develop hearing loss.
About 5 to 15% of newborns who do not have symptoms eventually develop neurologic problems (most commonly hearing loss). Some degree of hearing loss is the most common.
Prevention of CMV Infection in Newborns
Pregnant people should try to limit their exposure to the virus. For example, because CMV infection is common among children attending day care centers and easily spread, pregnant people should always wash their hands thoroughly after exposure to urine and saliva from children in day care.
Donated human milk can be pasteurized to reduce the risk of CMV transmission to newborns who are at increased risk of severe CMV infection after birth.
