Congenital cytomegalovirus is associated with severe forms of cerebral palsy and female sex in a retrospective population‐based study

Aim Congenital cytomegalovirus (c CMV ) infection can result in poor outcomes including cerebral palsy ( CP ). The aim of this study was to describe the incidence and comorbidities of CP reported to the A ustralian C erebral P alsy R egister ( ACPR ) as attributed to cCMV infection. Method This was a retrospective population‐based study. Cases were drawn from Australian state CP registers with population level ascertainment, 1993 to 2003 (n=2265; 56.4% males, Gross Motor Function Classification System [GMFCS] ratings available for Victorian cases only: 70% GMFCS levels I to III and 30% GMFCS levels IV to V). Clinical data were extracted and cases with cCMV reported as a known cause were compared with cases where cCMV was not reported. Results Children with c CMV ( n =34; 12 males, 22 females; mean [ SD ] gestational age, 36.4 wk [4.4], range 24–41 wk) accounted for 1.5% of CP cases; 2.9 per 100 000 live births, (95% confidence intervals 1.9–3.9). When compared with CP cases where c CMV was not reported, proportionally, more CP cases with c CMV were born to younger mothers ( p <0.001), were female (64% vs 43%, p =0.014), had spastic quadriplegia (73% vs 21%, p <0.001), required wheeled mobility i.e. GMFCS IV or V (78% vs 28%, p <0.001), had epilepsy (70% vs 30%, p <0.001), deafness (40% vs 2%, p <0.001), functional blindness (20% vs 5%, p <0.001), and severe communication impairment (71% vs 25%, p <0.001). Interpretation c CMV is an important potentially preventable cause of CP and is associated with severe disability and female sex in cases reported to the ACPR . Future studies utilising prospective sample collection for c CMV testing are needed to confirm these findings.