So Raymond J, Noij Kimberley S, Wang Jiangxia, Walsh Jonathan, Gourin Christine G, Jenks Carolyn M
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Otolaryngol Head Neck Surg. 2025 Apr;172(4):1409-1417. doi: 10.1002/ohn.1107. Epub 2025 Jan 5.
To analyze temporal changes and to assess the possible effect of newborn hearing screening (NBHS) programs on changes in congenital cytomegalovirus (cCMV) diagnostic rates in the United States.
Cross-sectional study.
National Inpatient Sample (NIS) database.
Neonates with cCMV infection were identified using discharge data from the NIS database from 1998 to 2019. Neonates with cCMV infection were identified via International Classification of Diseases codes and categorized as asymptomatic versus symptomatic and with or without hearing loss. Linear regression and interrupted time series analyses were conducted to analyze changes in diagnostic rates over time. Interrupted analyses were based on the timing of NBHS implementation in geographic regions.
Per 1,000,000 live births, the estimated total number of cCMV diagnoses increased from 109 in 1998 to 250 in 2019 (the estimated annual increase per 1,000,000 live births is 6.89 ([95% confidence interval, 5.43-8.35], P < .001). Diagnosis of cCMV with hearing loss showed a significant annual increase during this time (0.87 [0.51-1.22], P < .001), and within this group, diagnosis of both asymptomatic (0.18 [0.03-0.32], P = .02) and symptomatic (0.68 [0.37-0.99], P < .001) cases increased significantly. Compared to pre-NBHS, the rate of increase in cCMV diagnosis was significantly higher post-NBHS implementation in the Northeast (P < .001) and South (P = .008).
Implementation of state NBHS programs correlated with increasing diagnosis rates of cCMV, though cCMV education and awareness may be contributing. cCMV continues to be underdiagnosed in a large national database.
分析时间变化，并评估新生儿听力筛查（NBHS）项目对美国先天性巨细胞病毒（cCMV）诊断率变化的可能影响。
横断面研究。
国家住院样本（NIS）数据库。
利用1998年至2019年NIS数据库中的出院数据识别cCMV感染的新生儿。通过国际疾病分类编码识别cCMV感染的新生儿，并将其分为无症状与有症状以及有无听力损失。进行线性回归和中断时间序列分析以分析诊断率随时间的变化。中断分析基于NBHS在各地理区域的实施时间。
每100万例活产中，cCMV诊断的估计总数从1998年的109例增加到2019年的250例（每100万例活产的估计年增长率为6.89[95%置信区间，5.43 - 8.35]，P <.001）。在此期间，伴有听力损失的cCMV诊断显示出显著的年增长率（0.87[0.51 - 1.22]，P <.001），在该组中，无症状（0.18[0.03 - 0.32]，P =.02）和有症状（0.68[0.37 - 0.99]，P <.001）病例的诊断均显著增加。与NBHS实施前相比，东北部（P <.001）和南部（P =.008）在NBHS实施后cCMV诊断的增长率显著更高。
尽管cCMV教育和认知可能也有作用，但州NBHS项目的实施与cCMV诊断率的提高相关。在一个大型国家数据库中，cCMV仍未得到充分诊断。
