Neonatal Screening Programme for Increasing Early Postnatal Diagnosis of Congenital Cytomegalovirus Infection in the...

Congenital infection with cytomegalovirus (CMV) is the main cause of sensorineural hearing loss and psychomotor impairment which can develop at birth or later in infant's life. Because of a lack of nation-wide serological screening for pregnant women and accepted antiviral therapy during pregnancy in a high seroprevalence rate population of Poland, we introduced the regional screening programme for CMV infection in neonates from the Poznan Province to diminish a risk of the symptomatic disease. The aims of the study were: (i) to determine the prevalence of specific anti-CMV antibodies in populations of pregnant women and newborns from the Poznan area, (ii) to increase the early postnatal detection of congenital CMV infections, and (iii) to evaluate a risk of perinatal or early postnatal infections with CMV in newborns or infants born to seropositive mothers. Serological testing was performed in 4.192 live born neonates, using dried blood filter-paper specimens. The seropositivity rate in the studied population of neonates and pregnant women was 78.6%. The incidence of perinatal and early postnatal CMV infections was evaluated to be 3.1% or 1 per 25 neonates born to seropositive mothers. Congenital CMV infections confirmed by a presence of specific IgM antibodies were diagnosed in 5 newborns, which represent 1 case per 838 successive deliveries. In a clinical pattern of cytomegalovirus disease respiratory disorders and low birth weight were most frequently observed, and neurological signs, hepatitis, haemorrhagies or jaundice were sporadically diagnosed. Implementation of mass immunodiagnostic screening for congenital CMV infection, combined with other obligatory neonatal tests for metabolic errors, congenital malformations and endocrine disorders seems to be a valuable third line prophylactic strategy to prevent a late development of clinically overt cytomegalovirus disease.