A 10-year prospective study of sensorineural hearing loss in children with congenital cytomegalovirus infection.

OBJECTIVE: To determine the incidence, characteristics, and evolution of
sensorineural hearing loss (SNHL) in infants with a congenital cytomegalovirus
infection (cCMV). STUDY DESIGN: In a prospective 10-year study, 14 021 unselected
live-born infants were screened for cCMV by virus isolation in urine.
Congenitally infected newborns were evaluated for SNHL during the first 5 years
of life. RESULTS: A total of 74 of the 14 021 infants (0.53%) were congenitally
infected; of these, 4 (5.4%) were symptomatic at birth. Hearing testing could be
performed in 60 of the infants. SNHL was found in 21% of the asymptomatic and in
33% of symptomatic congenitally infected infants. Late-onset hearing loss was
detected in 5%, progression in 11%, fluctuation in 16%, and improved hearing
threshold in 18% of the infants with cCMV. SNHL was observed in 15% of infected
infants born after a maternal primary infection, in 7% born after a maternal
recurrent infection, and in 40% after a maternal infection of indeterminate
timing. CONCLUSIONS: In our study population, 0.53% of the infants had cCMV
infection, 22% of whom developed SNHL. Long-term follow up and repeated
audiologic testing is needed, because progression, fluctuation, improvement, and
late-onset hearing loss are important features of cCMV infection. The search for
a neonatal screening program to detect all cCMV is worthwhile.