Prenatal Screening for CMV Primary Infection: A Cost-Utility Model

Area of Science:

• Public Health
• Maternal and Child Health
• Health Economics

Background:

• Congenital cytomegalovirus (CMV) infection is a leading cause of childhood deafness and neurodevelopmental disabilities.
• Early detection and intervention are crucial for mitigating the long-term impacts of congenital CMV.

Purpose of the Study:

• To evaluate the cost-utility of universal first-trimester serological screening for CMV.
• To compare universal screening with targeted screening of high-risk pregnancies and no serological screening.

Main Methods:

• A decision-analytic model was developed to assess cost utility from a healthcare perspective.
• Three strategies were compared: universal first-trimester screening, high-risk screening, and no screening.
• Data on probabilities, expected values, and costs were sourced from published literature and Canadian healthcare data.

Main Results:

• Universal first-trimester screening demonstrated superior cost utility compared to high-risk screening and no screening.
• Sensitivity analyses confirmed universal screening as the most cost-effective strategy across various parameters.
• Universal screening is projected to detect 152 primary maternal CMV infections and prevent 29 congenital CMV infections annually.

Conclusions:

• The study supports the implementation of a population-based prenatal screening program for CMV.
• Universal screening is a cost-effective method for preventing congenital CMV infection and its associated disabilities.