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Hearing Targeted Screening for Congenital CMV: What are we Missing?

Abstract Summary

Purpose: After successfully implementing a hearing targeted screening for congenital CMV (cCMV) in a large academic birthing center, we questioned whether infants with a known sign of cCMV, microcephaly, were being recognized and screened for cCMV Methods: Medical records of infants delivered at Meriter Hospital in Madison, WI between 2019 -2022 were reviewed to identify infants with microcephaly (OFC < 3rd% on Fenton Growth Curves). Primary outcome measure was infants with microcephaly screened for cCMV. Secondary outcome measure was documentation of microcephaly in electronic medical record. Results: Between 2019-2022, 328 of 19,531 liveborn babies (1.7%) were microcephalic. cCMV screening was done on 24.4% of babies with microcephaly compared to 85% of babies who failed hearing screen. One infant with microcephaly and three infants with failed hearing screen had positive CMV PCR. Microcephaly was not documented in 73% of newborns with HC < 3rd%. Conclusions: Early identification of cCMV improves outcomes for affected newborns. Hearing targeted screening using saliva PCR is non-invasive with low false positive rate and has been successfully implemented in our nursery. In this review, we discovered that newborns with a known sign of cCMV, microcpehaly, were not being recognized as microcephalic and consequently not being screened for cCMV. Future PDSA cycles will seek to improve identification of microcephalic infants and cCMV screening in this population with the goal of improving outcomes in infants with cCMV.

Learning Objectives

• Understand gaps in knowledge of presentation of cCMV
• Understand area for improvement in cCMV screening
• Understand ways to improve identification of newborns with cCMV

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