Maternal–Fetal Infections (Cytomegalovirus, <i>Toxoplasma</i>, Syphilis): Short-Term and Long-Term Neurodevelopmental Outcomes in Children Infected and Uninfected at Birth
Cinzia Auriti,
Silvia Bucci,
Domenico Umberto De Rose,
Luana Coltella,
Alessandra Santisi,
Ludovica Martini,
Chiara Maddaloni,
Iliana Bersani,
Simona Lozzi,
Francesca Campi,
Concettina Pacifico,
Martina Balestri,
Daniela Longo,
Teresa Grimaldi
Affiliations
Cinzia Auriti
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Silvia Bucci
Department of Neurosciences, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Domenico Umberto De Rose
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Luana Coltella
Department of Microbiology and Virology, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Alessandra Santisi
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Ludovica Martini
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Chiara Maddaloni
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Iliana Bersani
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Simona Lozzi
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Francesca Campi
Medical and Surgical Department of Fetus-Newborn-Infant, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Concettina Pacifico
Audiology and Otosurgery Unit, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Martina Balestri
Department of Neurosciences, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Daniela Longo
Department of Imaging, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
Teresa Grimaldi
Department of Neurosciences, “Bambino Gesù” Children’s Hospital IRCCS, 00165 Rome, Italy
(1) Background: Infections in pregnancy can lead to miscarriage, premature birth, infections in newborns, and developmental disabilities in babies. Infected infants, symptomatic at birth, can have long-term sequelae, and asymptomatic babies are also at increased risk of developing long-term sensorineural outcomes. Targeted therapy of the pregnant mother can reduce fetal and neonatal harm. (2) Aim of the study: To explore the association between symptoms and time of onset of long-term sequelae in infected children born from mothers who contracted an infection during pregnancy, by a long-term multidisciplinary follow-up. (3) Methods: For up to 2–4 years, we evaluated cognitive, motor, audiological, visual, and language outcomes in infants with symptomatic and asymptomatic congenital infections and in uninfected infants. (4) Results: 186 infants born from women who acquired Cytomegalovirus infection (n = 103), Toxoplasma infection (n = 50), and Syphilis (n = 33) during pregnancy were observed. Among them, 119 infants acquired the infection in utero. Infected infants, symptomatic at birth, obtained lower scores on the Cognitive and Motor Scale on Bayley-III compared to asymptomatic and uninfected infants (p = 0.026; p = 0.049). Many severe or moderate sequelae rose up within the first year of life. At 24 months, we observed sequelae in 24.6% (14/57) of infected children classified as asymptomatic at birth, compared to 68.6% (24/35) of symptomatic ones (χ2 = 15.56; p < 0.001); (5) Conclusions: Infected babies symptomatic at birth have a worse prognosis than asymptomatic ones. Long-term sequelae may occur in infected children asymptomatic at birth after the first year of life. Multidisciplinary follow-up until 4–6 years of age should be performed in all infected children, regardless of the presence of symptoms at birth.
