Bronchopulmonary Dysplasia in Very Preterm Infants with Symptomatic Congenital Cytomegalovirus Infection: A Propensity Score-Matched Analysis

Abstract

Objective: To assess whether symptomatic congenital cytomegalovirus infection (cCMV) is associated with bronchopulmonary dysplasia (BPD) and mortality in very preterm infants (gestational age ≤32 weeks).

Study design: We performed a retrospective study using the Kids' Inpatient Database for 2003, 2006, 2009, and 2012. Diagnoses of BPD and symptomatic cCMV were determined using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Among patients with in-hospital birth at ≤32 weeks of gestation, cases of symptomatic cCMV were matched with infants without cCMV using propensity score matching at 1:2 ratio. Outcomes of BPD and in-hospital mortality were assessed using conditional logistic regression.

Results: Of 204 818 in-hospital births with gestational age ≤32 weeks, we identified 208 cases of symptomatic cCMV, 177 of which underwent matching. Symptomatic cCMV was associated with higher odds of BPD (OR, 2.34; 95% CI, 1.41-3.87), but was not significantly associated with in-hospital all-cause mortality (OR, 1.18, 95% CI, 0.64-2.17).

Conclusions: Symptomatic cCMV was associated with BPD but not with in-hospital mortality among very preterm infants. Further study is needed to determine the risk of BPD among infants with cCMV to allow for evaluation of possible preventive measures.

Keywords: mortality.