American Academy of Pediatrics broadens newborn screening for congenital CMV to catch infections earlier

The American Academy of Pediatrics has updated its guidelines to enhance early detection of congenital cytomegalovirus, aiming to identify cases sooner and reduce long-term developmental risks in newborns.

The American Academy of Pediatrics has updated its guidance for newborn screening of congenital cytomegalovirus, or cCMV, in a move aimed at finding more cases earlier and reducing the chances that the infection goes unnoticed. Cleveland Clinic said the change reflects growing concern that the virus, which is the most common congenital infection, is often missed because most newborns show no obvious signs at birth. Dr Frank Esper, an infectious diseases specialist at Cleveland Clinic Children’s, said the infection can later affect hearing and development, making early identification especially important.

According to the Academy’s new clinical report, paediatricians should use a hearing-targeted approach with expanded testing in babies who have risk factors, including abnormal prenatal imaging or HIV infection during pregnancy. The report also stresses the importance of better education for people of childbearing age about how to reduce the risk of infection. Cleveland Clinic said the revised approach is intended to make screening more consistent after previous policies varied widely between hospitals and regions.

The practical effect of the new guidance is that more newborns, especially those in neonatal intensive care units, will be tested automatically because they are at higher risk. Cleveland Clinic said the most common screening method is a saliva swab, with a positive result then confirmed through urine testing. Esper said targeted screening in the nursery has already shown it can sharply improve detection rates.

The Academy also recommends that infants who test positive be followed closely for hearing loss and developmental delays. That monitoring matters because, as Cleveland Clinic noted, about 90% of babies with congenital CMV do not show symptoms at birth. Antiviral treatment may also be used in some cases to help limit hearing loss, giving clinicians more tools to intervene before the infection causes lasting harm.