(1019) Efficacy of a Congenital Cytomegalovirus Targeted Screening Protocol

Introduction: Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of sensorineural hearing loss (SNHL), however 90% of infants with cCMV are asymptomatic. cCMV is associated with long-term symptoms such as hearing loss, developmental delay, and retinitis; accurate diagnosis within the first 3 weeks of life is essential to identify patients who may benefit from treatment. We designed and implemented a targeted screening protocol for cCMV in 2021 and hypothesize that targeted screening will increase early cCMV detection.

Methods: A cCMV targeted screening approach was implemented in June of 2021. Neonates under 21 days of life in the newborn nursery were tested for cCMV for referred newborn hearing screen, maternal Covid-19, symmetric SGA, maternal HIV, and occipital frontal circumference (OFC) below the tenth percentile. Metrics regarding total births, total cCMV tests ordered, total positive cCMV tests, and testing indications were gathered. A retrospective review and subsequent analysis were performed of these data spanning from January 2017-September 2023.

Results: The number of total cCMV tests ordered increased from an annual average of 82.8 prior to targeted screening implementation to 692 after targeted screening implementation (p = 0.0036). The number of annual total positive cCMV tests increased from an average of 0.6 per year prior to targeted screening to an average of 5.67 per year after implementation (p = 0.0132). The average total number of annual live births prior to versus after screening increased from 3325 to 3597 (p = 0.0908).

Conclusions: This preliminary analysis suggests that a targeted screening approach is associated with statistically significant higher rates of CMV testing and accurate detection of cCMV cases within the first 21 days of life. As the total number of births did not differ significantly before versus after targeted screening implementation, the increased incidence of cCMV positive tests cannot be attributed to an increased birth rate. Our results also indicate that a failed hearing screen in the first 21 days of life is the most common indication for cCMV testing.