Hearing Trajectories in Congenital Cytomegalovirus Infection: A 4-Year Follow-Up Study

To investigate long-term hearing evolution in children with congenital cytomegalovirus (cCMV) and to identify predictive factors for hearing impairment.

A retrospective, single-center study in a tertiary pediatric otolaryngology referral center in Paris. The study included 244 patients with cCMV born between January 2013 and December 2018, with documented infection and at least 4 years of hearing follow-up. Data collected included prenatal history, diagnosis, birth symptoms, additional investigations, and therapy. Hearing thresholds were measured every 6 months for 2 years and then annually.

At birth, cCMV-related sensorineural hearing loss (SNHL) prevalence in this cohort was 10%. At age 4, prevalence increased to 15% overall (35% of symptomatic and 2% of asymptomatic patients). No significant fluctuations were observed except with intercurrent otitis media with effusion. Risk factors for SNHL included cerebral imaging abnormalities (OR = 7.4 [95% CI 3-20.1], P < .001), clinical symptoms at birth (OR = 5.9 [95% CI 1.8-19.6], P < .01), affected contralateral ear at birth (OR = 6.7 [95% CI 2.9-15.4], P < .001), and first-trimester infection (OR = 3.7 [95% CI 1.6-9.6], P < .01).

Identifiable risk factors for SNHL may guide management and parental counseling of patients with cCMV.