THE RISK of developing autism spectrum disorder (ASD) is higher in children who were diagnosed with congenital cytomegalovirus (cCMV), according to recent research. Whilst often harmless, this virus can cause long-term health issues and has been linked to the development of central nervous system (CNS) disorders (possibly due to the impact of inflammation on fetal brain development). Therefore, researchers investigated the association between cCMV and ASD development in particular.
They analysed data on nearly 3 million children enrolled in Medicaid or the Children’s Health Insurance Program from birth. Among 2,989,659 children, 1044 (0.035%) had been diagnosed with cCMV, and 74,872 (2.500%) were diagnosed with ASD between birth and 7 years. It was revealed that children with cCMV were 2.5 times more likely to have an ASD diagnosis (hazard ratio: 2.5; 95% CI: 2.0-3.2). This association differed by sex, as female participants with cCMV were 4.65 times more likely to have an ASD diagnosed, whereas the risk of ASD in males was nearly 2 times the risk compared to their peers without cCMV. The analysis also revealed that 49% of those with cCMV had CNS anomaly or injury, such as brain anomaly, microcephaly within 45 days of birth, cerebral palsy, epilepsy, or chorioretinitis, and this may account for some of the risk; however, they also saw links between cCMV and autism in children without brain anomalies, preterm birth or low birth weight.
In conclusion, children with cCMV were 2.5 times more likely to have an ASD diagnosis. Future research should aim to elucidate the pathophysiology that underlies this link, in order to identify potential therapeutic options. Furthermore, longitudinal analysis of larger cohorts, perhaps through universal screening programs, may provide further insight. Additionally, this study highlights that clinicians should consider proactive monitoring for early signs of ASD in children diagnosed with cCMV.
Katrina Thornber, EMJ
Reference
Pesch MH et al. Autism spectrum disorder diagnoses and congenital cytomegalovirus. Pediatrics. 2024;153(6):e2023064081.
