Original article
A 10-Year Prospective Study of Sensorineural Hearing Loss in Children with Congenital Cytomegalovirus Infection

https://doi.org/10.1016/j.jpeds.2007.12.049Get rights and content

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.

Section snippets

Methods

The study protocol was approved by the Committee of Medical Ethics of the Universitair Ziekenhuis Brussel.

Results

Of the 14 021 infants born in UZ Brussels Hospital between June 1996 and November 2006, 74 (0.53%) were diagnosed with a cCMV infection (33 boys and 41 girls). Four of these infants (5.4%) had a symptomatic infection, and 70 (94.6%) had an asymptomatic infection. A total of 13 infants were lost to follow-up, and 1 infant with a symptomatic cCMV infection died before a hearing test could be performed. Hearing tests were conducted in the remaining 60 congenitally infected infants (3 symptomatic

Discussion

Among 14 000 unselected live-born infants studied prospectively over a 10-year period in a single hospital, the incidence of cCMV was 0.53%, with 5.4% of cases symptomatic. Hearing loss was found in 22% of the cCMV-infected infants (21% of the asymptomatic and 33% of the symptomatic infected infants). Previous studies have put the incidence of SNHL at 6% to 25%9, 10, 11 in infants with asymptomatic cCMV infection and 22% to 65% in infants with symptomatic cCMV infection.11 The incidence of SNHL

References (21)

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