(1048) Outcomes of Targeted Congenital Cytomegalovirus Testing at Texas Children's Hospital

Introduction: Congenital cytomegalovirus (cCMV) infection is the leading nongenetic cause of sensorineural hearing loss (SNHL) in infants. Of newborns with cCMV, 90% are asymptomatic, making adequate screening and detection procedures essential for early diagnosis. Targeted cCMV testing with implementation of a newborn screening program has shown efficacy in other countries; however, it has not been widely implemented in the United States. Our tertiary care referral center implemented targeted cCMV testing on all infants who failed their newborn hearing screen (NBHS), and our study examines the outcomes of this implementation.

Methods: A retrospective chart review was performed on patients seen at our tertiary care referral center who received cCMV testing within the first 3 weeks of life following a failed NBHS between October 2013 and February 2022. Data collection included patient and maternal demographics, comorbidities, type of cCMV test and NBHS performed, and diagnostic hearing test results, when applicable. Statistical analyses were performed using the Kruskal-Wallace test and chi squared tests with statistical significance p < 0.05.

Results: In total, 233 patients were evaluated for this study, 7 of which tested positive for cCMV. Of the 7, 42.9% (n = 3) that had cCMV were subsequently diagnosed with SNHL. The presence of fetal comorbidities (p = 0.0012), maternal age at birth (p = 0.0049), and gestational complications (p = 0.0002) all had increased rates of cCMV.

Conclusions: Our protocol identified 3 cCMV patients who were subsequently diagnosed with SNHL. This prompt recognition and diagnosis allowed for early interventions to mitigate negative audiologic and neurodevelopmental outcomes. Patients with fetal comorbidities, younger maternal age, and gestational complications were associated with higher rates of cCMV and should have special consideration for NBHS.