Abstract Details
10/09/2023 | 10:00 AM - 10:25 AM | 6619
Expanded CMV newborn screening: adding intrauterine growth restriction diagnosis to targeted CMV screening in newborns
Abstract Summary
Background: Intrauterine growth restriction (IUGR) is considered a sign of congenital cytomegalovirus (cCMV) when it occurs among a constellation of other CMV-related symptoms. Although it is unknown if IUGR alone could indicate cCMV, some targeted newborn cCMV screening programs are considering IUGR for an expanded cCMV screening approach. Objective: To determine the frequency of IUGR among infants screened for cCMV and whether IUGR could be used for an expanded cCMV screening approach. Methods: Between 2007 and 2012, 12,192 infants from UAB Hospital were enrolled in the CHIMES study. Saliva specimens and dried blood spots (DBS) were collected from the newborns and tested for CMV by PCR. IUGR is defined as birth weight below the 10th percentile for gestational age and includes both asymmetric and symmetric IUGR. Results: The study cohort was 53% non-Hispanic Black, 22% Hispanic, 22% non-Hispanic White, 1% Asian, and 2% multiracial. cCMV was identified in 98 (8 per 1000) newborns among 12,192 liveborn infants. IUGR was significantly higher among cCMV infants than uninfected infants (24.5% vs. 7.7%, RR=3.2, 95% CI, 2.2 – 4.5). Even after adjusting for race/ethnicity, maternal age, parity, and socioeconomic status, the association between cCMV and IUGR remained (RR=2.7, 95% CI, 1.9 – 3.8). IUGR was the only sign of cCMV in 17/98 (17.3%) infants. If targeted cCMV screening had been implemented in this cohort, only 70% of CMV-related hearing loss would have been identified. If targeted cCMV screening was expanded to add IUGR, 90% of CMV-related hearing loss in the total cohort would have been identified. Conclusions: These findings support the consideration of CMV testing in infants with IUGR. An expanded cCMV screening program in newborns could identify most early CMV-related hearing loss; however, this approach would still miss late-onset hearing loss among infants with cCMV.
Learning Objectives
- Define an expanded cCMV screening approach
- Define the frequency of IUGR among infants with cCMV
- Define the frequency of CMV-related hearing loss identified by expanded screening
Presentation
3440589_16106SureshBoppana.pdf
Handouts
No handouts have been uploaded.
Presenters
Suresh Boppana | Author
sboppana@uab.edu;
Suresh Boppana is a Professor of Pediatrics and Microbiology and Hugh Dillon Endowed Professor in Pediatric Infectious Diseases at the University of Alabama at Birmingham.
ASHA DISCLOSURE
Financial - Receives Consulting fee,Grants for Consulting,Other activities from Merck and Pfizer: Research Grants; GSK: consultant.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - Receives support from Merck Pfizer GSK for Merck and Pfizer: Research Grant to my institution GSK: Member of CMV Vaccine Advisory Committee.
Shannon Ross | Author
saross@uabmc.edu;
Dr. Ross is a Professor in the Division of Infectious Diseases, in the Department of Pediatrics at the University of Alabama at Birmingham
ASHA DISCLOSURE
Financial -
Nonfinancial -
AAA DISCLOSURE
Financial - No relevant financial relationship exists.
Karen B. Fowler | Primary Presenter
kfowler@uab.edu;
Dr. Fowler is a Professor in the Division of Infectious Diseases in the Department of Pediatrics at the University of Alabama at Birmingham.
ASHA DISCLOSURE
Financial - Receives Honoraria excluding diversified mutual funds for Teaching and speaking from Medscape. Receives Consulting fee for Consulting from Moderna.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - Receives support from Moderna Medscape for financial.