title: Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection.
abstract: OBJECTIVE
  To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children.
  
  
  METHODS
  We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan-Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups.
  
  
  RESULTS
  At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%-36%) among case-patients and 8% (95% CI: 3%-22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2-14.5;P= .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4-6.1;P= .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5-19.1;P< .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%-9%).
  
  
  CONCLUSIONS
  Delayed-onset and progression of SNHL among children with asymptomatic congenital cytomegalovirus infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation.
authors.affiliation: National Center for Immunization and Respiratory Diseases, and tmlanzieri@cdc.gov.
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Lanzieri
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Winnie
authors.initials: W
authors.lastname: Chung
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: Marily
authors.initials: M
authors.lastname: Flores
authors.affiliation: Texas Children's Hospital, Houston, Texas; and.
authors.forename: Peggy
authors.initials: P
authors.lastname: Blum
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
authors.forename: A Chantal
authors.initials: AC
authors.lastname: Caviness
authors.affiliation: National Center for Immunization and Respiratory Diseases, and.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Bialek
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.|P3S Corporation, San Antonio, Texas.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Miller
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, Texas.|Texas Children's Hospital, Houston, Texas; and.
authors.forename: Gail
authors.initials: G
authors.lastname: Demmler-Harrison
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D058345:Asymptomatic Infections / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000175:diagnosis* / Q000453:epidemiology; D003638:Deafness / Q000453:epidemiology / Q000821:virology; D018450:Disease Progression; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D015995:Prevalence; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology