Uncovering the link between a common congenital viral infection and autism

Study: Babies born with the infectious birth defect, congenital cytomegalovirus, are nearly 2.5 times more likely to be diagnosed with autism spectrum disorder

2:53 PM

Author | Beata Mostafavi

pink baby in floating cell with colorful brain purple spotted background
Jacob Dwyer, Michigan Medicine

Children who contracted a viral infection known as congenital cytomegalovirus in utero may be nearly two and half times more likely to be diagnosed with autism, a study suggests.

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 other long term health problems. 

Complications may include vision or hearing loss and a higher risk of cerebral palsy, epilepsy and developmental delays.

The risk of having an autism diagnosis was more than four and a half times more likely among females born with the condition compared to those without it and twice as likely for male babies, according to the study in the American Academy of Pediatrics journal Pediatrics.

“Our findings suggest a potentially heightened risk of autism among children born with a congenital CMV infection,” said lead author Megan Pesch, M.D., a developmental behavioral pediatrician at University of Michigan Health C.S. Mott Children’s Hospital whose daughter has both diagnoses.

“This data should prompt us as clinicians to proactively monitor for early signs of autism in children with congenital cytomegalovirus. This may be especially critical for children who are deaf or hard of hearing since diagnosing autism in this population can be particularly challenging.”

Researchers analyzed insurance claims for nearly three million children using Medicaid or the Children's Health Insurance Program.

Improving early detection

An estimated one in three pregnant people passes a CMV infection on to their babies when the virus passes through the placenta. 

When this occurs, Pesch says, it may activate an inflammatory state that could potentially impact fetal brain development and increase the risk of autism.  

Pesch is among clinicians who have advocated for routine neonatal screening for CMV, which often doesn’t show any 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,” Pesch said.

Autism is a neurological and developmental condition that affects how people interact, communicate and learn. 

This data should prompt us as clinicians to proactively monitor for early signs of autism in children with congenital cytomegalovirus. This may be especially critical for children who are deaf or hard of hearing since diagnosing autism in this population can be particularly challenging.” Megan Pesch, M.D.

People of the spectrum tend to have particular preferences for social interactions, communication, and sensory experiences. 

For instance, some autistic people may find eye contact to be uncomfortable, but find great joy in the sensation of jumping, or they may be particularly passionate about seemingly unusual topics (e.g. model trains, or dinosaurs.)   

Experts believe its development is likely influenced by diverse genetic and environmental factors, including the intrauterine environment. 

Previous research has identified associations between certain prenatal exposures to some viruses and the risk of autism.

There was no association, Pesch notes, between CMV and autism in children who had a congenital central nervous system anomaly, 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,” 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” 

Additional authors include Jessica Leung, M.P.H. and Tatiana Lanzieri, M.D., M.P.H., of the National Center for Immunization and Respiratory Diseases; and Sarah Tinker, Ph.D.; Charles Rose, Ph.D.; Melissa Danielson, MSPH; Marshalyn Yeargin-Allsopp, M.D., and Scott Grosse, Ph.D., of the National Center on Birth Defects and Development Disabilities, Centers for Disease Control and Prevention. 

Disclosures: Pesch serves on the executive board for the national CMV Foundation in an unpaid position.

Paper cited: “Autism Spectrum Disorder Diagnoses and Congenital Cytomegalovirus,” PediatricsDOI: 10.1542/peds.2023-064081

Sign up for Health Lab newsletters today. Get medical tips from top experts and learn about new scientific discoveries every week by subscribing to Health Lab’s two newsletters, Health & Wellness and Research & Innovation.

Sign up for the Health Lab Podcast: Add us on SpotifyApple Podcasts or wherever you get you listen to your favorite shows.


More Articles About: Neonatal Care Pediatric Children's Health C.S. Mott Children’s Hospital Human Growth and Development Ear, Nose & Throat Hearing Problems Autism Genetic Disorders Developmental Milestones Neurological (Brain) Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

In This Story
profile-megan-pesch-2017 Megan H Pesch

Clinical Assistant Professor

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories purple background sky colors with times floating patient with pillow brown clothes on moon in sky
Health Lab
Free course shines light on sleep health
An expert-led course on sleep helps educate students about the importance of creating and maintaining good sleep habits for health and wellness.
older woman lying in bed
Health Lab
Sleep apnea contributes to dementia in older adults, especially women
Obstructive sleep apnea, a common and underdiagnosed sleep disorder, contributes to dementia in older adults — particularly women, a study suggests.
close up of airpod in ear while old man with glasses drives and light brown leather seats in car
Health Lab
Should you try Apple’s hearing aid app? An audiologist weighs in
Apple has marketed its AirPods Pro 2 as soon having “clinical-grade Hearing Aid capability.” Devin McCaslin, Ph.D., an audiologist, answers some questions about the hearing aids market and about the new AirPods.
teen tossing pills into his mouth burnt orange background and blue shirt
Health Lab
Should teens use protein supplements?
A report highlights that many teens are using protein supplements, particularly protein powders, to improve their athletic performance and build muscle.
Health Lab
Rare neuromuscular condition doesn’t stop teen from track & field dream
Michigan teen Jake Juip becomes 100-meter Michigan state high school champion in adaptive track and field race using adaptive equipment designed to meet the needs of his rare neuromuscular condition.
man in wheelchair talking to other man with back to camera in jean shirt in living room looking setting with tree in corner
Health Lab
For multiple sclerosis, medication and cognitive behavioral therapy can reduce fatigue
In a study of commonly used treatments for multiple sclerosis, both medical and behavioral interventions, and a combination of the two, resulted in significant improvements in fatigue.