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Published on: July 6, 2013
Importance of congenital cytomegalovirus in the neonatal hearing screening program
Juan David Gutiérrez Posso1, José Antonio Anta Escuredo1, Ana Aguirre Unceta-Barrenechea2
1Servicio de Otorrinolaringología, Hospital Universitario Basurto, Bilbao, Spain.
Insights
Congenital Cytomegalovirus (CMV) infection can cause hearing loss in newborns. Including CMV DNA testing in neonatal screening can lead to early diagnosis and intervention, improving developmental outcomes.
Area of Science:
- Neonatal screening
- Pediatric audiology
- Infectious disease diagnostics
Background:
- Congenital Cytomegalovirus (CMV) infection is a rare but significant cause of hearing loss in newborns.
- Hearing loss can negatively impact a child's development and social integration.
- Early detection and intervention are crucial for managing the effects of congenital CMV.
Purpose of the Study:
- To evaluate the effectiveness of including CMV DNA determination as part of neonatal hearing screening.
- To analyze the timelines for detection, confirmation, and intervention in newborns with hearing loss potentially caused by CMV.
- To highlight the role of CMV PCR in early diagnosis and interdisciplinary treatment.
Main Methods:
- A 5-year retrospective study was conducted in the Basque Country.
- Newborns who failed initial hearing screening were assessed for congenital CMV.
- Data on detection, confirmation (incidence), and intervention (treatment) times were collected and analyzed.
Main Results:
- Out of 18,782 newborns screened, 58 (3/1000 live births) had hearing loss.
- Congenital CMV was confirmed in 4 patients (0.21/1000 live births).
- Mean times were: hearing screening (6.5 days), CMV detection by PCR (4.2 days), hearing loss confirmation (2.2 months), and audiological intervention (5 months).
- Four hearing aids and one cochlear implant were fitted.
Conclusions:
- Neonatal hearing screening is an effective public health program.
- CMV DNA determination via PCR enables early, specific diagnosis and treatment.
- The study underscores the importance of incorporating CMV PCR into universal neonatal screening protocols.
- Otorhinolaryngology plays a key role in the interdisciplinary management of congenital CMV-related hearing loss.
Introduction:
In newborns, hearing loss secondary to congenital Cytomegalovirus (CMVc) infection, despite its low prevalence, can cause a serious problem in the personal development and social integration of patients. Therefore, it is important to include the determination of CMV DNA as a neonatal screening tool.
Materials And Methods:
We have carried out a 5-year retrospective study, by describing the CMVc in the Autonomous Community of the Basque Country in newborns who did not pass the hearing screening in the early hearing loss detection program. The times of detection, confirmation (incidence) and intervention (treatment) are described.
Results:
Of 18,782 subjects studied, 58 (three per thousand live births) presented hearing loss. Of these, CMVc is guaranteed in four patients (one woman and three men). The mean time to hearing screening was 6.5 days (SD: ±3.69) and to detect CMV by polymerase chain reaction (PCR) in urine and saliva was 4.2 days (SD: ± 3.94). Time to confirm hearing loss by BAEP and audiological intervention 2.2 (SD: ±0.957) and 5 months (SD: ±3.741), respectively. Four hearing aid adaptations and one cochlear implant were performed.
Discussion And Conclusion:
Neonatal hearing screening has established itself as a good public health program. The determination of viral DNA allows an early, specific and interdisciplinary diagnosis and treatment, in which otorhinolaryngology plays a fundamental role. Our study highlights the importance of including CMV PCR as a universal screening tool.
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