Neurobehavioral outcomes of neonatal asymptomatic congenital cytomegalovirus infection at 12-months

BACKGROUND

Congenital cytomegalovirus (cCMV) is the most common congenital viral infection in the United States. Symptomatic infections can cause severe hearing loss and neurological disability, although ~ 90% of cCMV infections are asymptomatic at birth. Despite its prevalence, the long-term neurobehavioral risks of asymptomatic cCMV infections are not fully understood. The objective of this work was to evaluate for potential long-term neurobehavioral sequelae in infants with asymptomatic cCMV.

METHODS

Infants with cCMV were identified from a universal newborn cCMV screening study in a metropolitan area in the midwestern United States. Asymptomatic infants with cCMV were enrolled in a longitudinal neurodevelopmental study (N = 29). Age- and sex-matched healthy control infants (N = 193) were identified from the Baby Connectome Project (BCP), a longitudinal study of brain and behavioral development. The BCP sample supplemented an additional group of healthy control infants (N = 30), recruited from the same participant registry as the BCP specifically for comparison with infants with asymptomatic cCMV. Neurobehavioral assessments and parent questionnaires, including the Mullen Scales of Early Learning, the Repetitive Behavior Scales for Early Childhood (RBS-EC), and the Infant Toddler Social Emotional Assessment (ITSEA) were administered at 12 months of age. Neurobehavioral scores were compared between infants with asymptomatic cCMV and all identified healthy control infants.

RESULTS

Infants with asymptomatic cCMV performed equivalently compared to healthy control infants on the neurobehavioral measures tested at 12 months of age.

CONCLUSIONS

These results indicate that at 12 months of age, infants with asymptomatic cCMV are not statistically different from controls in a number of neurobehavioral domains. Although follow-up is ongoing, these observations provide reassurance about neurobehavioral outcomes for infants with asymptomatic cCMV and inform the ongoing discussion around universal screening. Additional follow-up will be necessary to understand the longer-term outcomes of these children.

The role of forensic anthropology in the recovery and analysis of Branch Davidian compound victims: assessing the accuracy of age estimations

Age-at-death estimations of 44 individuals (27 adults, 17 children) from the Branch Davidian sample were compared with their actual ages. Estimations were evaluated for bias and accuracy for the actual age at death. Although the overall average estimates correlated well with the actual ages (r = 0.946), several individuals displayed high residual requiring further analysis and review. These individuals displayed age-related features that did not correspond with the expected morphology for individuals of their ages. Several age estimation techniques scored these individuals with all bias in the same direction. These examples should serve as cautionary reminders that biology does not always correlate with expected outcomes, particularly in such multifaceted traits such as age.

The role of forensic anthropology in the recovery and analysis of Branch Davidian Compound victims: recovery procedures and characteristics of the victims

Anthropological contributions to the investigation of the events at the Branch Davidian Compound near Waco, Texas in early 1993, were of two major types: the recovery of human remains from the site and the analysis of most of those individuals at the Medical Examiner's Office in Fort Worth, Texas. This paper describes the role of forensic anthropology in the recovery and analysis of Branch Davidian Compound victims and the recovery procedures and characteristics of the victims.