Newborn Screening for Congenital Cytomegalovirus (cCMV) Infection: Universal, Targeted, Expanded-Targeted, or...

Area of Science:

• Pediatrics
• Infectious Diseases
• Public Health

Background:

• Congenital cytomegalovirus (cCMV) is the leading cause of neurodevelopmental disabilities in US infants.
• Sensorineural hearing loss (SNHL) is the most frequent long-term consequence of cCMV.
• Over 40% of infants with cCMV-related SNHL pass newborn hearing screens, highlighting a critical detection gap.

Purpose of the Study:

• To review the rationale and evidence supporting universal cCMV screening in newborns.
• To discuss the benefits of early cCMV identification, including timely antiviral therapy.
• To examine the challenges and concerns associated with universal cCMV screening policies.

Main Methods:

• Literature review of studies on cCMV screening, diagnosis, and outcomes.
• Analysis of the pros and cons of universal versus targeted screening approaches.
• Consideration of diagnostic timing for cCMV (within 21 days of birth).

Main Results:

• Universal screening offers a strategy to identify more infants with cCMV at risk for SNHL.
• Early diagnosis facilitates prompt initiation of antiviral treatments, potentially improving clinical outcomes.
• Hesitancy exists due to unproven cost-effectiveness and concerns about parental anxiety from screening asymptomatic infants.

Conclusions:

• There is a strong rationale for universal cCMV screening to detect SNHL risk.
• Balancing the benefits of early detection against cost and parental anxiety is crucial.
• Emerging screening approaches require consideration for neonatologists in clinical practice.