Diener Marissa L, Zick Cathleen D, McVicar Stephanie Browning, Boettger Jill, Park Albert H
Departments of Family and Consumer Studies and
Departments of Family and Consumer Studies and.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-0789.
Cytomegalovirus (CMV) is the most common congenital infection and nongenetic cause of congenital sensorineural hearing loss in the United States. Utah was the first state to pass legislation mandating CMV screening for newborns who fail newborn hearing screening (NBHS). The study objective was to present outcomes of hearing-targeted CMV screening and determine factors predicting CMV screening.
We used Utah Department of Health HiTrack and Vital Records databases to examine CMV screening from 509 infants who failed NBHS in the 24 months after implementation of the Utah legislation. Multivariate logistic regression analyses were conducted to identify predictors of compliance with CMV screening and diagnostic hearing evaluation.
Sixty-two percent of infants who never passed hearing screening underwent CMV screening. Fourteen of 234 infants tested within 21 days were CMV positive; 6 (42.9%) had hearing loss. Seventy-seven percent of eligible infants completed a diagnostic hearing evaluation within 90 days of birth. Compliance with CMV screening was associated with sociodemographic factors, time since the law was enacted, and NBHS protocol. Infants born after the legislation showed greater odds of achieving timely diagnostic hearing evaluation than infants born before the law.
Incorporating CMV screening into an established NBHS program is a viable option for the identification of CMV in infants failing NBHS. The addition of CMV testing can help a NBHS program attain timely audiological diagnostics within 90 days, an important early hearing detection and intervention milestone.
在美国，巨细胞病毒（CMV）是先天性感染的最常见病因，也是先天性感音神经性听力损失的非遗传病因。犹他州是首个通过立法强制要求对新生儿听力筛查（NBHS）未通过的新生儿进行CMV筛查的州。本研究的目的是呈现以听力为目标的CMV筛查结果，并确定预测CMV筛查的因素。
我们使用犹他州卫生部的HiTrack和生命记录数据库，对犹他州立法实施后24个月内NBHS未通过的509名婴儿的CMV筛查情况进行了检查。进行多因素逻辑回归分析，以确定CMV筛查和诊断性听力评估的依从性预测因素。
从未通过听力筛查的婴儿中有62%接受了CMV筛查。在21天内接受检测的234名婴儿中有14名CMV呈阳性；其中6名（42.9%）有听力损失。77%的符合条件的婴儿在出生后90天内完成了诊断性听力评估。CMV筛查的依从性与社会人口统计学因素、法律颁布后的时间以及NBHS方案有关。立法后出生的婴儿比立法前出生的婴儿更有可能及时进行诊断性听力评估。
将CMV筛查纳入既定的NBHS计划是识别NBHS未通过婴儿中CMV的可行选择。增加CMV检测有助于NBHS计划在90天内实现及时的听力学诊断，这是早期听力检测和干预的一个重要里程碑。
