VANCOUVER, B.C. – A targeted cytomegalovirus screening approach that tests only newborns who do not pass their hearing test would identify the majority of those who have CMV-related sensorineural hearing loss at birth, according to data from the CMV and Hearing Multicenter Screening Study.
All of 99,778 newborns born during 2007-2012 in seven states studied had both auditory testing and virologic testing of saliva for CMV infection shortly after birth.
Dr. Karen B. Fowler
Overall, 461 (0.5%) tested positive for CMV infection, lead investigator Karen B. Fowler, Dr.P.H., a professor at the University of Alabama, Birmingham, reported at the annual meeting of the Pediatric Academic Societies.
The proportion of newborns who did not pass their hearing test and were therefore referred for further evaluation was higher in the CMV-positive group than in the CMV-negative group (7.1% vs. 0.9%; P less than .0001). Findings were similar whether the newborn was in the well-baby nursery or in the neonatal intensive care unit.
Hearing screening identified 21 (60%) of the 35 newborns with CMV-related sensorineural hearing loss. However, this amounted to only 4.5% of all CMV-positive infants in the cohort.
"Our study found that infants who are CMV positive will refer or not pass their newborn hearing screening at a significantly higher rate than infants without CMV infection, suggesting that newborns who refer on their hearing screen and have no other known etiology for their possible hearing loss should be screened for CMV infection," Dr. Fowler said in an interview.
This targeted approach "does not identify all infants with congenital CMV infection or all CMV-related hearing loss. However, our study found that 60% of the CMV-related hearing loss that occurs in the newborn period was identified using this approach," she added.
As for clinical implications, "infants who are CMV positive with sensorineural hearing loss will need continued monitoring of their hearing loss for further deterioration, as well as possible antiviral treatment. Those infants who are CMV positive, even if further evaluation indicates that hearing loss is not present, will need continued monitoring for possible late-onset hearing loss. Although appropriate early intervention should occur for any infant with hearing loss, monitoring for late-onset and progressive hearing losses might not occur for CMV-positive infants if the etiology of the hearing loss was unknown," noted Dr. Fowler.
The investigators plan "to continue to explore possible mechanisms of CMV-related hearing loss and whether there are predictors or indicators of which children with CMV infection will go on to have hearing loss or further deterioration of their hearing loss. Currently, no such indicators exist," she concluded.
Dr. Fowler disclosed no relevant conflicts of interest.