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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.
[congenital toxoplasmosis]
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
.
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
)
.
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
)
.
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
.