CONGENITAL CYTOMEGALOVIRUS-INFECTION AND NEONATAL AUDITORY SCREENING

Auditory screening of newborn infants has been recommended on the basi s of the presence of risk criteria, including congenital infection. We assessed the ability of risk criteria-based neonatal auditory brain s tem response to identify infants with hearing loss resulting from cong enital cytomegalovirus (CMV) infection. Data from 6 1/2 years of risk criteria-based neonatal auditory screening were compared with the resu lts of screening of all newborn infants for congenital CMV infection. Infants with congenital CMV infection received follow-up hearing evalu ations. Congenital CMV infection was found in 167 (1.3%) of 12,371 inf ants; 134 had follow-up hearing evaluations, and 14 (10.4%) had confir med sensorineural hearing loss. The rate of sensorineural hearing loss resulting from congenital CMV infection was 14 per 12,371 infants, of 1.1 per 1000 live births; the rate of bilateral loss greater-than-or- equal-to 50 dB was 0.6 per 1000. Although 2036 infants received audito ry screening because of risk criteria, only 34 (20%) of 167 infants wi th congenital CMV infection were included. Only 2 (14%) of 14 children with sensorineural hearing loss caused by CMV were identified by risk criteria-based screening. We conclude that congenital CMV infection i s an important cause of hearing impairment. Neonatal auditory screenin g based on the presence of risk criteria will fail to identify the maj ority of cases of sensorineural hearing loss caused by congenital CMV infection.