Children born with a viral infection called congenital cytomegalovirus (CMV) may be nearly two and a half times more likely to be diagnosed with autism, according to a recent study.
Congenital CMV is the most common congenital infection in the United States, affecting one in every 200 babies. While most infants with congenital CMV are healthy, nearly one in five experience birth defects or long-term health problems.
These complications can include vision or hearing loss, a higher risk of cerebral palsy, epilepsy, and developmental delays.
The study, published in the journal Pediatrics by the American Academy of Pediatrics, found that the risk of an autism diagnosis was more than four and a half times higher among females born with congenital CMV compared to those without it, and twice as likely for males.
“Our findings suggest a potentially heightened risk of autism among children born with a congenital CMV infection,” said Dr. Megan Pesch, the study’s lead author and a developmental behavioral pediatrician at University of Michigan Health C.S. Mott Children’s Hospital.
Dr. Pesch, whose daughter has both congenital CMV and autism, emphasized the importance of monitoring for early signs of autism in children with this infection, particularly those who are deaf or hard of hearing, as diagnosing autism in this population can be especially challenging.
Researchers analyzed insurance claims for nearly three million children using Medicaid or the Children’s Health Insurance Program.
They found that an estimated one in three pregnant individuals passes a CMV infection to their babies through the placenta. When this occurs, it may trigger an inflammatory response that could impact fetal brain development and increase the risk of autism.
Dr. Pesch advocates for routine neonatal screening for CMV, as the infection often shows no symptoms during pregnancy or at birth.
“More states in the U.S. and parts of Canada have recently implemented congenital CMV screening programs, which provides an opportunity for early intervention,” she said.
Autism is a neurological and developmental condition that affects how people interact, communicate, and learn. People on the autism spectrum may have unique preferences for social interactions, communication, and sensory experiences.
For example, some autistic individuals may find eye contact uncomfortable but derive great joy from activities like jumping or have intense interests in specific topics, such as model trains or dinosaurs.
Experts believe the development of autism is influenced by a combination of genetic and environmental factors, including conditions in the womb.
Previous research has identified associations between certain prenatal exposures to viruses and the risk of autism.
However, Dr. Pesch notes that there was no association between CMV and autism in children with congenital central nervous system anomalies, such as structural or functional abnormalities of the brain and spinal cord that occur during fetal development.
“We need further research to better understand the relationship between CMV and autism,” Dr. Pesch said.
“Universal congenital CMV screening may not only improve detection before symptoms develop and lead to more timely intervention but also help us clarify the risk of autism among this population. Most importantly, this provides an opportunity to best support these children and their families.”
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The research findings can be found in Pediatrics.
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