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Pediatrics. 2017 Feb;139(2). pii: e20162128. doi: 10.1542/peds.2016-2128. Epub 2017 Jan 3.

A Targeted Approach for Congenital Cytomegalovirus Screening Within Newborn Hearing Screening.

Author information

1
Department of Pediatrics and Epidemiology, kfowler@uab.edu.
2
Department of Special Education (Retired), University of Alabama, Tuscaloosa, Alabama.
3
Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
4
Department of Otolaryngology, University of Texas Southwestern Medical Center at Dallas, Parkland Hospital, Children's Health, Dallas, Texas.
5
Civitan-Sparks Clinics, Department of Pediatrics, and.
6
Department of Speech and Audiology, Carolinas Rehabilitation, Carolinas HealthCare System, Charlotte, North Carolina; and.
7
Department of Otolaryngology - Head & Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
8
Department of Pediatrics and Microbiology, University of Alabama at Birmingham, Birmingham, Alabama.

Abstract

BACKGROUND AND OBJECTIVE:

Congenital cytomegalovirus (cCMV) infection remains a leading cause of childhood hearing loss. Currently universal CMV screening at birth does not exist in the United States. An alternative approach could be testing infants who do not pass their newborn hearing screening (NHS) for cCMV. This study was undertaken to evaluate whether a targeted approach will identify infants with CMV-related sensorineural hearing loss (SNHL).

METHODS:

Infants born at 7 US medical centers received NHS and were also screened for cCMV while in the newborn nursery. Infants who tested positive for CMV received further diagnostic audiologic evaluations to identify or confirm hearing loss.

RESULTS:

Between 2007 and 2012, 99 945 newborns were screened for both hearing impairment and cCMV. Overall, 7.0% of CMV-positive infants did not pass NHS compared with 0.9% of CMV-negative infants (P < .0001). Among the cCMV infants who failed NHS, diagnostic testing confirmed that 65% had SNHL. In addition, 3.6% of CMV-infected infants who passed their NHS had SNHL confirmed by further evaluation during early infancy. NHS in this cohort identified 57% of all CMV-related SNHL that occurred in the neonatal period.

CONCLUSIONS:

A targeted CMV approach that tests newborns who fail their NHS identified the majority of infants with CMV-related SNHL at birth. However, 43% of the infants with CMV-related SNHL in the neonatal period and cCMV infants who are at risk for late onset SNHL were not identified by NHS.

PMID:
28049114
PMCID:
PMC5260148
DOI:
10.1542/peds.2016-2128
[Indexed for MEDLINE]
Free PMC Article

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