PP1106 - The First Two Years: Regional Data from Universal cCMV Audiological Monitoring in Minnesota

Abstract:
Minnesota became the first state in the United States to begin universal newborn cCMV screening on 2/6/2023. The Minnesota Department of Health (MDH) established a working group prior to its implementation to review the literature and provide guidelines for Audiological follow-up for infants with confirmed cCMV. This Poster reviews the monitoring results from infants followed by the Mayo Clinic in Rochester and Mankato, Minnesota using the initial guidelines from the working group, and highlights the positive findings, along with addressing challenges and proposals for potential future modification of these guidelines.
Summary:
Cytomegalovirus (CMV is a member of the herpes virus family and is transmitted by bodily fluids. Congenital CMV occurs when the CMV infection is passed from a pregnant person to their fetus. Approximately 1 per 200 infants are born with cCMV. 10% are symptomatic at birth. Symptomatic infants have two or more features present with CNS involvement. Signs at birth can include microcephaly, petechiae, jaundice, hepatosplenomegaly, and hearing loss. Long-term health problems include hearing loss (30-50%), vision loss (22-58%), intellectual disabilities (55-66%), cerebral palsy, seizures, and death. 90% of cCMV infants are asymptomatic at birth, and 10% of these babies will develop permanent hearing loss by age four.

Congenital CMV cannot be distinguished from acquired CMV in a newborn beyond 21 days of age, so early detection is key. Early detection leads to early identification of hearing loss and the option of antiviral treatment for those who might benefit. Vestibular disorders occur frequently in children with both symptomatic and asymptomatic cCMV. To ensure optimal outcomes, Infants diagnosed with cCMV need frequent audiological monitoring to detect emerging hearing loss or vestibular dysfunction, identify the progression of existing hearing loss, and plan appropriate interventions.

A working group of pediatric clinical and educational audiologists from across Minnesota collaborated with the Minnesota newborn Hearing Screening Advisory Committee (NHSAC) to review relevant research and best practices. The group then proposed a monitoring protocol which will be outlined in detail in the poster.

The audiologic monitoring was reviewed for infants born or referred to Rochester and Mankato, Minnesota since the beginning of statewide universal screening for cCMV.  The data from two sites during this period of approximately two years of monitoring will be shared.  In addition, the poster will address the challenges and successes experienced, as well as discuss opportunities for future monitoring guidelines.