The Impact of Mandated Universal Screening for Congenital Cytomegalovirus: The Minnesota Experience.

Abstract

To investigate trends in evaluation and management of patients with cCMV at a major pediatric center following the institution of universal cCMV screening. Retrospective cohort study. Tertiary academic hospital. Patients <18 years with a diagnosis of cCMV between January 2021 and February 2024 were examined. Three cohorts were analyzed: 2021 and earlier (before screening guidelines), 2022 (screening recommended but not mandated), and 2023 and later (universal screening). Patient charts were reviewed for workup and treatment of cCMV. 132 patients met criteria. There was a significant difference in age at first audiology visit following cCMV diagnosis between cohorts 1 (0.71 ± 1.8), 2 (0.26 ± 0.23), and 3 (0.07 ± 0.06) (P = .02). There was a significant increase in the absolute number of mild hearing loss diagnoses in 2023 and later compared to 2022 (8 and 2, P < .01), but no difference in severe to profound hearing loss diagnoses between the cohorts (5 and 3, P = .2). Between cohorts 2 and 3, there were increases in the absolute number of patients undergoing ID consultation (11 vs 24), ENT consultation (9 vs 22), and treatment with antiviral therapy (7 vs 9) (P < .01). Universal cCMV screening decreased the age at first audiology visit following cCMV diagnosis. Universal screening increased the number of diagnoses of mild hearing loss. The number of patients undergoing workup for cCMV also increased. Additional research is needed to assess the long-term audiologic outcomes and benefits of universal screening.