Routine newborn screening could catch cytomegalovirus infections before problems appear
A newborn can look perfectly healthy, pass a hearing test and still carry an infection that may affect hearing or development later in childhood. That is the challenge posed by congenital cytomegalovirus, or cCMV, one of the most common infections passed from a mother to a baby during pregnancy. Most babies born with the virus show no obvious signs at birth, making it difficult to know which…
A study conducted at Hadassah Medical Center in Jerusalem has found that screening all newborns for congenital cytomegalovirus (cCMV) could uncover many cases that would otherwise go undetected. The research, published in The Lancet Infectious Diseases, examined 48,556 newborns and identified 176 with congenital CMV, or roughly 3.6 cases per 1,000 babies screened.
Routine testing typically occurs when there are specific indicators such as a failed hearing test, signs of illness, or a known maternal infection. However, 57% of the identified cases would have been missed by this targeted approach, highlighting the importance of universal screening. Among the 100 babies missed without universal screening, eight later showed moderate to severe symptoms, three had hearing loss despite appearing healthy, and eleven received antiviral treatment.
The study used a pooled saliva-testing system, which significantly reduced the number of laboratory tests needed by 83% compared to individual testing, while maintaining high detection sensitivity. This method combined saliva samples from several babies and tested them together using PCR. If a pooled sample tested positive, individual investigation followed, with positive saliva results confirmed through urine testing.
While routine newborn hearing tests are still crucial, the findings emphasize that they cannot detect every CMV-affected baby. Some babies discovered only through universal screening had sensorineural hearing loss, and at one year, a small proportion had permanent hearing or balance-related issues. The study also noted that some effects may only become apparent later, underscoring the need for long-term follow-up.
Additionally, the research found that congenital CMV is not exclusive to first-time maternal infections, with 53% of cases occurring in mothers who had previously been exposed to CMV. Further research is needed to assess the cost-effectiveness of universal screening before widespread implementation can be determined.
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