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439 UNIVERSAL SCREENING OF NEWBORN INFANTS FOR CONGENITAL CYTOMEGALOVIRUS INFECTION AND HEARING LOSS

Purpose Congenital cytomegalovirus (CMV) infection is an important cause of permanent hearing loss in children. Detection of congenital CMV infection allows early identification of infants at risk of hearing loss. The study objective is to determine if universal screening of newborns for CMV is a useful adjunct to universal hearing screening. Methods Between 3/8/04 and 8/29/04, infants born at four Utah hospitals in the Salt Lake Valley were screened for congenital CMV infection by cell culture assay of saliva. Each sample was run in duplicate. The population sampled corresponded to 31% (1555/5090) of the infants born at the hospitals during the study interval. Concurrently, all infants underwent hearing assessment. Normal newborn nurseries used otoacoustic emission (OAE) screening, whereas Newborn Intensive Care Units used OAE or automated auditory brainstem evoked response (AABR) audiometry for initial hearing assessment. Results Six infants (0.39%) were congenitally infected with CMV. None of the CMV positive infants failed the newborn hearing screen. The cost of the CMV assay was approximately $20 per infant, corresponding to approximately $5200/CMV-positive infant. Concurrently, 98% of the 5090 infants passed their initial hearing screen. On subsequent evaluation, 2 infants who failed their initial screen have normal hearing. Follow-up evaluations of the remaining 20 infants are in progress. Conclusions This study demonstrates the feasibility of universal screening for CMV. Compared with other regions of the United States, Utah appears to be a low prevalence state for congenital CMV infection. Using the approaches employed in this study, the cost of statewide screening for CMV would be approximately $1.1 million annually. Universal hearing screening alone will not identify infants at risk of subsequent hearing loss due to congenital CMV infection.