Pediatrics (P)
Shannon McGee, BS
Audiology Extern
Nemours Children's Health, Delaware
Newark, Delaware
Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.
Julie M. Verhoff, AuD,PhD (she/her/hers)
Audiology Manager
Audiology Manager
Wilmington, Delaware
Disclosure(s): No financial relationships to disclose
Congenital Cytomegalovirus (CMV) is the most common viral infection, and the leading cause of non-genetic congenital hearing loss and neurodevelopmental disorders in newborns, infants, and children in the United States (Andronaco, 2020). Most people with CMV infections have no symptoms and are not aware that they have been infected. Symptomatic congenital disease occurs most often during fetal development through maternal infection. According to the Center for Disease Control and Prevention (CDC), CMV is the most common infectious cause of birth defects in the United States (2022).
CMV is transmitted through bodily fluids such as saliva, urine, breast mild, and blood. Once contracted, CMV remains in a person’s body and can reactivate. It is estimated that between 50% and 80% of the U.S. population have had a CMV infection by the time they are 40 years of age (National CMV Foundation, n.d.). Approximately 30% to 40% of infected pregnant women transmit the infection to their fetus (Andronaco, 2020). The risk of congenital infection in utero is greatest when the mother contracts a primary infection after contraception; the risk is greatest during the first or early second trimester (Andronaco, 2020). Maternal infection with CMV before a current pregnancy does not provide complete protection for the fetus, but it has been shown to decrease the risk of transmission.
It is estimated that 90% of newborns infected with CMV are asymptomatic at birth (Andronaco, 2020). However, CMV symptoms can present after birth, usually within the first few years of life. About 80% of children with congenital CMV never develop any symptoms, however, 20% have problems related to breathing, hearing, vision, and neurological disabilities.
Currently, less than a hand full of states in the U.S. have a universal newborn CMV screening. A small number of states require maternal education and targeted newborn CMV screening. In many states, CMV is discovered after a child refers on a newborn hearing screening. However, in those children who are asymptomatic at birth, CMV is often left undiagnosed until the child is older.
Children who are asymptomatic at birth and show delayed symptoms often are left undiagnosed for an extended period of time. It is well established that early intervention often results in a more positive outcome. However, children who are not diagnosed with hearing loss after infancy and toddlerhood experience auditory deprivation, which may explain the variability in outcomes. However, it is well observed that even those children diagnosed with CMV who received cochlear implants early show high variability in outcomes.
This poster will review and compare outcomes in children with cochlear implants and CMV at Nemours Children’s Health, Delaware. A retrospective case review from a pediatric hospital for children with cochlear implants secondary to CMV. Assessment questionnaires were used to evaluate outcome measures. These questionnaires include LittleEars, Parents’ Evaluation of Aural/Oral Performance of Children (PEACH) and the Abbreviated Profile of Hearing Aid Benefit (APHAB).