Reducing Congenital CMV

March 20, 2009

A new vaccine for cytomegalovirus in women has the potential to protect their fetuses during pregnancy.

Good news for pregnant mothers: according to an article in the current issue of the New England Journal of Medicine, a new vaccine for cytomegalovirus (CMV) in women has the potential to protect their fetuses during pregnancy. CMV is currently the most common congenital infection in the United States, and the March of Dimes reports that an estimated 15% of children who are infected in the womb show symptoms at birth. Approximately 10% of children with congenital CMV go on to develop neurological abnormalities, some of which are very serious or even fatal.

The phase 2, placebo-controlled, randomized, double-blind study included 464 non-pregnant, CMV-negative women aged 14 to 40 years, who were given three doses of the vaccine (N=234) or placebo (N=230) over a period of 6 months. The researchers found that CMV infections developed in 18 women receiving the vaccine and 31 women in the control group. Further more, analysis showed that women who received the vaccine were significantly more likely to remain uninfected over a 42 month period (P=0.02). And of the 97 women in the vaccine group and 118 controls that became pregnant after vaccination, 1 congenital CMV infection occurred among 81 live births in the vaccine group compared with 3 cases among 97 live births among controls.

There’s the good news, and now I’ll pose a question. What is your experience with central auditory processing disorder (CAPD)? I’m not finding consensus among professionals as to whether or not CAPD is anything other than the “diagnosis du jour,” as one pediatrician told me. There seems to be emerging information regarding CAPD as something truly separate from ADHD (although the two disorders are admittedly difficult to tease apart) that audiologists and neurologists put real credence in. Yet in school, the issue is often the same—children with CAPD who do not meet the profile of any category of ADHD still have difficulty sustaining attention.

I’m curious as to the approach of individual pediatricians in treating these children. There certainly could be maturational effects as the child grows, so auditory monitoring from year to year may be advised. However, that doesn’t necessarily address the issue in school. Are stimulants sometimes effective, and if so, with which CAPD subtypes? Inquiring minds want to know!