Retrospective screening for congenital cytomegalovirus infection in the Survey of Neonates in Pomerania shows very low disease burden.

Abstract

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is considered one of the most common infectious pathologies in neonates, showing a wide range of clinical manifestations, ranging from completely asymptomatic to critically ill newborns. Primary infection during the first trimester of pregnancy carries the highest risk of severe fetal involvement. However, the majority of infected fetuses show an asymptomatic or mild course of disease. The most common long-term sequela is sensorineural hearing loss, which is detected in only about 50% of affected children during newborn hearing screenings. Furthermore, epidemiological data on disease burden remain limited and show considerable variability. The aim of this study was to investigate the prevalence of cCMV and its associated disease burden at follow-up, particular sensorineural hearing loss, in a population-based birth cohort. RESULTS: We conducted a retrospective analysis for cCMV in n = 1995 newborns using urine and plasma biosamples from the second baseline cohort of the Survey of Neonates in Pomerania (SNiP-II). Four participants (prevalence rate 0.2%) were tested positive. Two of these cases had already been identified shortly after birth, having been screened for cCMV due to clinical suspicion. The seroprevalence of IgG antibodies among pregnant women was 47.6%. For follow-up, the patient database of our Department of Otolaryngology, Head and Neck Surgery (ENT) was reviewed for hearing pathologies in all children born during the SNiP-II recruitment period (2013–2017). Twelve out of n = 1138 SNiP-II participants (1.1%) showed confirmed sensorineural hearing loss (SNHL), none of which were associated with cCMV. A complete clinical follow-up of the cCMV-positive cases revealed no sequelae related to the infection. CONCLUSIONS: By using a population-based retrospective analysis approach, we demonstrated a very low prevalence and disease burden of cCMV in our region. Our data supports the current guideline recommendations of a risk factor-based screening strategy.