Congenital cytomegalovirus-related hospitalizations in infants <1 year of age, United States, 1997-2009

Abstract

Background: An estimated 3600 infants born with congenital cytomegalovirus (cCMV) infection annually in the United States are symptomatic at birth. The proportion of infants with symptomatic cCMV infection who require hospitalization is unknown yet important for understanding the full disease and economic burdens of cCMV.

Methods: Data from the Healthcare Cost and Utilization Project Kids' Inpatient Databases were analyzed to determine numbers and rates of cCMV-related hospitalizations among infants for 1997, 2000, 2003, 2006 and 2009, the years the survey was conducted. A cCMV-related hospitalization was defined as a hospitalization with an International Classification of Diseases, 9th revision, Clinical Modification code of 771.1 in an infant without HIV or transplant-related codes. After applying hospital type-specific cost-to-charge ratios and adjusting to 2012 US dollars, total medical costs associated with cCMV-related hospitalizations were assessed. Results were extrapolated to represent national estimates.

Results: Among infants <1 year of age in the United States, an estimated annual average of 747 cCMV-related hospitalizations (18.6/100,000 per year) were coded during the 5 study years; 408 (55%) were among infants <1 month of age (122.0/100,000 per year). Approximately 4% of hospitalizations among infants <1 year resulted in death. Total estimated annual cost associated with cCMV-related hospitalizations among the US infants <1 year was at least $14.3 million.

Conclusions: cCMV infection is associated with substantial numbers of hospitalizations, medical costs and mortality among the US infants. The true burden and costs of cCMV disease are likely much higher than our estimates when underascertainment of cCMV and total costs related to services and hospitalizations beyond the first year of life are considered.