Clinical and functional characteristics of cerebral ischemia in newborns from mothers with exacerbation of cytomegalovirus infection during pregnancy

Introduction. Despite the known role of antenatal virus-associated brain damage in the neurological status impairment of newborns, there is a lack of studies addressing the clinical features of cytomegalovirus (CMV) infection. Aim. To provide a clinical and functional characterization of cerebral ischemia in newborns from mothers with exacerbation of CMV infection in the second trimester of pregnancy.
Materials and methods. Clinical and anamnestic data, Apgar scores, body weight, and resistance index in the anterior cerebral artery were studied in 30 newborns from mothers with uncomplicated pregnancies (control group) and 70 newborns from mothers who experienced an exacerbation of CMV infection in the second trimester of pregnancy (main group), including 38 with grade I cerebral ischemia (first subgroup) and 32 with grade II cerebral ischemia (second subgroup).
Results. Newborns in the first subgroup exhibited signs of intrauterine hypoxia, characterized by a lower Apgar score at 1 (p<0.001) and 5 minutes (p<0.001) compared to the control group. Average body weight values were also reduced (p<0.01). Changes in neuro-reflex status manifested as hyperexcitability and motor disorders. The resistance index in the anterior cerebral artery did not differ significantly (p>0.05). In the second subgroup, Apgar scores at 1 (p<0.001) and 5 minutes (p<0.001), as well as average weight indicators (p<0.01 and p<0.001), were lower than in the control group and the first subgroup. The clinical picture was dominated by hypertensive-hydrocephalic syndrome and suppression syndrome, with some cases showing signs of hyperexcitability and convulsive syndrome. Doppler imaging revealed an increase in the resistance index in the anterior cerebral artery (p<0.001).
Conclusion. Newborns from mothers with exacerbation of CMV infection in the second trimester of pregnancy exhibit hypertensive-hydrocephalic syndrome and suppression of neuro-reflex activity depending on the severity of cerebral ischemia, against a background of reduced blood flow in the anterior cerebral artery. Impaired cerebral hemodynamics in such newborns at birth may increase the risk of reduced adaptation in the postnatal developmental period.

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