Date Created

3-2026

Document Type

Scholarly Project

Degree Name

Doctor of Audiology

Department

College of Natural and Health Sciences, Communication Sciences and Disorders, CSD Student Work

First Advisor

Hannah Glick

First Committee Member

Caitlin Raaz

Second Committee Member

Diane Erdbruegger

Abstract

Congenital cytomegalovirus (cCMV) is the most common congenital infection in developed countries and a leading non-genetic cause of sensorineural hearing loss (SNHL) and neurodevelopmental impairment in children. Despite its significant public health impact, newborn screening policies for cCMV remain inconsistent across the United States. Recent policy developments, including Minnesota’s implementation of universal newborn cCMV screening (2023) and Colorado’s adoption of an expanded-targeted screening approach (2025), have intensified discussion regarding optimal strategies for early detection and intervention. This narrative review synthesizes current evidence on the epidemiology, clinical manifestations, diagnostic methods, treatment options, and long-term outcomes of cCMV, with a particular focus on screening approaches and their implications for clinical practice and health policy in Colorado.

This narrative review highlights that while most infants with cCMV are asymptomatic at birth, they remain at risk for delayed-onset SNHL, vestibular dysfunction, and neurodevelopmental delays affecting speech, cognition, and motor development. Diagnostic strategies, including saliva and urine polymerase chain reaction (PCR) testing and emerging dried blood spot (DBS) methods, are evaluated for sensitivity, feasibility, and scalability. Current management emphasizes antiviral therapy in select symptomatic cases alongside comprehensive, multidisciplinary follow-up care involving audiology, vestibular assessment, ophthalmology, and early intervention services.

Comparative analysis of screening models indicates that targeted and expanded-targeted approaches, while resource-conscious, fail to identify a substantial proportion of affected infants who may develop later-onset sequelae. In contrast, universal screening demonstrates improved case detection, earlier intervention, and potential benefits for health equity, as illustrated by Minnesota’s model. However, implementation considerations, including cost-effectiveness, infrastructure demands, and care coordination, remain critical barriers to widespread adoption.

Overall, evidence synthesized in this review suggests that universal newborn cCMV screening may provide the most comprehensive framework for early identification and prevention of long-term disability. The findings support continued evaluation of Minnesota’s model as a benchmark for policy development and underscore the need for longitudinal, economic, and implementation research to guide potential expansion of universal screening in Colorado.

Abstract Format

html

Keywords

Congenital cytomegalovirus (cCMV); universal newborn hearing screening; sensorineural hearing loss (SNHL); polymerase chain reaction (PCR) screening; dried blood spot (DBS) screening

Subject Categories

Speech Pathology and Audiology

Language

English

Places

Greeley, Colorado

Extent

28 pages

Rights Statement

Copyright is held by the author.

Digital Origin

Born digital

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