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Hearing-Targeted Congenital Cytomegalovirus Screening: An 11-Year Experience
Aanchal Wats1, Barbara L Araujo1, Camila Aparicio-Llorente1
1Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, Connecticut.
Pediatrics
|July 19, 2026
Summary
Connecticut's mandate for congenital cytomegalovirus (cCMV) testing significantly increased diagnosis rates in newborns. However, many infants with cCMV still develop long-term hearing loss and neurodevelopmental issues, suggesting limitations in current screening.
Area of Science:
- Public Health
- Pediatrics
- Infectious Diseases
Background:
- Congenital cytomegalovirus (cCMV) is a primary cause of sensorineural hearing loss in infants.
- Many cCMV cases are undiagnosed at birth, leading to missed opportunities for early intervention.
- Connecticut implemented a mandate for cCMV testing in newborns failing hearing screenings in 2016.
Purpose of the Study:
- To evaluate the impact of Connecticut's cCMV testing mandate on diagnosis rates.
- To characterize the long-term audiologic and neurodevelopmental outcomes of infants diagnosed with cCMV post-mandate.
Main Methods:
- An interrupted time series study (2013-2023) analyzed data from a health system serving 60% of Connecticut's population.
- Confirmed cCMV cases involved laboratory detection within 21 days of life; probable cases had compatible findings with later or less definitive testing.
- Long-term outcomes were tracked through June 2025.
Main Results:
- The mandate resulted in a 4.32-fold increase in annual cCMV diagnoses.
- Post-mandate, 28% of diagnosed infants were asymptomatic or had isolated hearing loss, with 75% developing sequelae.
- Among infants with cCMV and hearing loss at birth, 81% experienced worsening hearing, and only 21% remained without sequelae.
Conclusions:
- Hearing-targeted screening effectively increased cCMV detection in infants who might otherwise have been missed.
- Despite improved detection, a significant number of cCMV infections likely remain undiagnosed, highlighting screening limitations.
- The findings support the value of hearing-targeted screening while emphasizing the need to consider universal screening for cCMV.
