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A pilot study using residual newborn dried blood spots to assess the potential role of cytomegalovirus and Toxoplasma gondii in the etiology of congenital hydrocephalus

Authors

  • Regina M. Simeone,

    Corresponding author
    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
    2. Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
    • Correspondence to: Regina Simeone, 1600 Clifton Rd, Mailstop E-86, Centers for Disease Control and Prevention, Atlanta GA 30341. E-mail: rsimeone@cdc.gov

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  • Sonja A. Rasmussen,

    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Joanne V. Mei,

    1. Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Sheila C. Dollard,

    1. Division of Viral Diseases, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Jaime L. Frias,

    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
    2. McKing Consulting Corporation, Fairfax, Virginia
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  • Gary M. Shaw,

    1. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Stanford, California
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  • Mark A. Canfield,

    1. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
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  • Robert E. Meyer,

    1. Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Division of Public Health, Raleigh, North Carolina
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  • Jeffrey L. Jones,

    1. Division of Parasitic Diseases and Malaria, Center for Global Health, Atlanta, Georgia
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  • Fred Lorey,

    1. Genetic Disease Branch, California Department of Public Health, Richmond, California
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  • Margaret A. Honein

    1. Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or of the California Department of Public Health.

Abstract

Background

Congenital hydrocephalus is a condition characterized by accumulation of cerebrospinal fluid in the ventricles of the brain. Prenatal infections are risk factors for some birth defects. This pilot study investigated whether residual dried blood spots (DBS) could be used to assess infections as risk factors for birth defects by examining the associations between prenatal infection with Toxoplasma gondii (T. gondii) or cytomegalovirus (CMV) with congenital hydrocephalus.

Methods

Case-infants with hydrocephalus (N = 410) were identified among live-born infants using birth defects surveillance systems in California, North Carolina, and Texas. Control-infants without birth defects were randomly selected from the same geographic areas and time periods as case-infants (N = 448). We tested residual DBS from case- and control-infants for T. gondii immunoglobulin M and CMV DNA. When possible, we calculated crude odds ratios (cORs) and confidence intervals (CIs).

Results

Evidence for prenatal T. gondii infection was more common among case-infants (1.2%) than control-infants (0%; p = 0.11), and evidence for prenatal CMV infection was higher among case-infants (1.5%) than control-infants (0.7%; cOR: 2.3; 95% CI: 0.48, 13.99).

Conclusions

Prenatal infections with T. gondii and CMV occurred more often among infants with congenital hydrocephalus than control-infants, although differences were not statistically significant. This pilot study highlighted some challenges in using DBS to examine associations between certain infections and birth defects, particularly related to reduced sensitivity and specimen storage conditions. Further study with increased numbers of specimens and higher quality specimens should be considered to understand better the contribution of these infections to the occurrence of congenital hydrocephalus. Birth Defects Research (Part A) 97:431–436, 2013. © 2013 Wiley Periodicals, Inc.

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