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Published on: July 6, 2013
Newborn screening for congenital cytomegalovirus: Options for hospital-based and public health programs
Scott D Grosse1, Sheila Dollard, Danielle S Ross
1National Center on Birth Defects and Developmental Disabilities, USA. sgrosse@cdc.gov
Insights
Screening newborns for congenital cytomegalovirus (CMV) infection can improve outcomes for affected infants. Further research is needed to address screening challenges and demonstrate its value.
Area of Science:
- Neonatal screening
- Infectious disease surveillance
Background:
- Congenital cytomegalovirus (CMV) is a primary cause of sensorineural hearing loss and developmental delays in children.
- Early detection through screening can facilitate timely interventions for affected infants.
Purpose of the Study:
- To explore screening strategies for congenital CMV in newborns.
- To identify barriers to screening and data requirements for policy development.
Main Methods:
- Literature review and expert opinion synthesis.
- Analysis of newborn screening methods including dried blood spot and urine assays.
- Consideration of newborn hearing screening programs and Early Hearing Detection and Intervention (EHDI).
Main Results:
- No current population-based screening for congenital CMV exists; pilot studies are ongoing.
- Practical challenges include assay sensitivity and specimen collection infrastructure.
- Evidentiary challenges involve demonstrating improved outcomes and screening value.
Conclusions:
- Congenital CMV screening is a promising intervention requiring further investigation.
- Research should focus on logistical feasibility and the psychosocial impact on families.
Background:
Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL) and developmental disability in children. Early identification of infected children through screening could allow for early intervention and improvement in functional outcomes among the subset who develop sequelae.
Objectives:
To outline potential options and strategies for screening newborns for congenital CMV infection and to discuss barriers to screening and data needs to inform future policy decisions.
Study Design:
Commentary based on the literature and expert opinion on newborn dried blood spot screening, newborn hearing screening/Early Hearing Detection and Intervention (EHDI) programs, and congenital CMV.
Results:
Although no population-based screening for congenital CMV is underway, pilot newborn screening studies using a variety of assays with urine or dried blood spot specimens are underway. Challenges to screening are both practical-uncertain sensitivity of blood spot assays suitable for large-scale screening and lack of infrastructure for collection of urine specimens; and evidentiary-the need to demonstrate improved outcomes and value of screening to offset the expense and potential adverse psychosocial consequences for children and families whose children require periodic monitoring but never develop sequelae.
Conclusions:
Screening for congenital CMV infection is a potentially important intervention that merits additional research, including the logistical feasibility of different screening options and psychosocial consequences for families.
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