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).


METHODS
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.
Foulon
Ina
I
Department of Otolaryngology and Head and Neck Surgery, University Hospital Brussels, Free University Brussels, Belgium. ina.foulon@uzbrussel.be
Naessens
Anne
A
Foulon
Walter
W
Casteels
Ann
A
Gordts
Frans
F
D001299:Audiometry; D003587:Cytomegalovirus / Q000378:metabolism*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000175:diagnosis* / Q000821:virology*; D006320:Hearing Tests; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D009035:Mothers; D015997:Neonatal Screening; D011446:Prospective Studies; D012307:Risk Factors