Hearing and neurodevelopmental outcomes among children with congenital cytomegalovirus

Objective: Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and the leading non-genetic cause of sensorineural hearing loss. We assessed demographics, clinical characteristics, hearing and neurodevelopmental outcomes by 6 years of age among U.S. children with possible cCMV. Study design: Retrospective cohort design. Setting: The Audiological and Genetic Database (AudGenDB) includes 175,216 pediatric patients who underwent audiology, otology or genetic visits during 2006-2019 in Children's Hospital of Philadelphia, Vanderbilt Children's Hospital, or Boston Children's Hospital. Methods: Children with possible cCMV were identified by diagnostic codes for cCMV infection and CMV disease up to 6 years of age. We examined clinical signs of cCMV during 0-45 days of birth and neurodevelopmental conditions (including hearing loss) up to 6 years of age. Hearing loss was defined as pure tone average or any frequency threshold >= 25 dB. Results: A total of 180 (0.1 %) children with possible cCMV were identified; 70 % had diagnosis codes after 45 days of life. The proportions of Black and Hispanic/Latino children comprised a higher proportion in the possible cCMV group compared to the non-cCMV group. Overall, 129 (72 %) children with possible cCMV had diagnoses codes for neurodevelopmental conditions, including hearing loss (56), communication delays (45) and cerebral palsy (22). Hearing loss was diagnosed at a median age of 2 (1-4) years. Conclusion: Neurodevelopmental delays were common among children with possible cCMV included in this study. AudGenDB provides access to longitudinal outcomes for a large and diverse cohort that remains helpful in lieu of state-mandated screenings.