Viruses (Jul 2024)

Useful Clinical Criteria for Identifying Neonates with Congenital Cytomegalovirus Infection at Birth in the Context of an Expanded Targeted Screening Program

  • Valeria Poletti de Chaurand,
  • Gaia Scandella,
  • Marianna Zicoia,
  • Francesca Arienti,
  • Federica Fernicola,
  • Laura Lanteri,
  • Diletta Guglielmi,
  • Anna Carli,
  • Maria Viola Vasarri,
  • Lucia Iozzi,
  • Annalisa Cavallero,
  • Sergio Maria Ivano Malandrin,
  • Anna Locatelli,
  • Maria Luisa Ventura,
  • Mariateresa Sinelli,
  • Sara Ornaghi

DOI
https://doi.org/10.3390/v16071138
Journal volume & issue
Vol. 16, no. 7
p. 1138

Abstract

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Cytomegalovirus (CMV) is the leading infectious cause of brain defects and neurological dysfunctions, including sensorineural hearing loss (SNHL). Targeted screening in neonates failing the hearing screen is currently recommended in Italy according to national guidelines. However, SNHL may not be present at birth; also, congenital CMV (cCMV) may manifest with subtle signs other than SNHL. Therefore, the inclusion of additional criteria for cCMV screening appears clinically valuable. Starting January 2021, we have implemented expanded targeted cCMV screening at our center, with testing in case of maternal CMV infection during pregnancy, inadequate antenatal care, maternal HIV infection or immunosuppression, birthweight and/or head circumference < 10th centile, failed hearing screen, and prematurity. During the first three years of use of this program (2021–2023), 940 (12.3%) of 7651 live-born infants were tested. The most common indication was birthweight < 10th centile (n = 633, 67.3%). Eleven neonates were diagnosed as congenitally infected, for a prevalence of 1.17% (95%CI 0.48–1.86) on tested neonates and of 0.14% (95%CI 0.06–0.23) on live-born infants. None of the cCMV-infected newborns had a failed hearing screen as a testing indication. Implementation of an expanded cCMV screening program appears feasible and of clinical value.

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