Newborn Screening
Types of congenital CMV screening programs
How to test for cCMV
NEWBORN SCREENING PROTOCOLS
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Congenital cytomegalovirus (cCMV) can only be confirmed in the first few weeks of life, so early testing is critical. Testing identifies babies who were infected before birth and ensures they receive timely care and follow-up.
When to Test
-If a baby fails the newborn hearing screen in one or both ears
- If a baby shows signs of cCMV such as small head size, jaundice, low birth weight, or an enlarged liver or spleen
- If the mother had a CMV infection during pregnancy
- If a baby is born or stillborn - we believe that all babies should be tested for congenital CMV regardless of symptoms
How Testing is Done
-PCR Test: A quick and painless swab of the baby’s mouth.
- Urine PCR Test: Often used to confirm a positive saliva result.
- Blood Test: Less common but may also detect CMV.
- Dried Blood Spot testing: less accurate than saliva or urine testing, but some states will automatically order this testing for certain babies with risk factors for cCMV.
Importance of Timing
Testing must be done within the first 21 days of life. After this time, it’s hard to tell if the infection happened before or after birth. Later testing can only be done through Dried Blood Spot testing.
Check out our full guide to congenital CMV testing
Many hospital systems and
several states test newborns for congenital CMV at birth. Early diagnosis allows for treatment and monitoring for the infant, and for families to be prepared.
The National CMV Foundation supports
universal newborn congenital CMV screening; in other words we believe that all babies should be screened at birth.
If your baby is older than three weeks, families interested in obtaining their baby's dried blood spot (DBS) for testing should ask their physician to call the appropriate contact per this Newborn Blood Spot Screening list by state. More information is available by looking up your state on the Baby's First Test
website.
There are at least three Clinical Laboratory Improvement Amendments (CLIA) validated labs that can run DBS CMV PCR assays, including ARUP at the University of Utah, the University of Washington Virology Laboratory, and the University of Minnesota Center for Infectious Diseases and Microbiology Translational Research.
Check out these great examples of real-life newborn screening programs and protocols in action!
Universal/Routine Screening
All infants are screened for congenital CMV at birth. With the right type of test, this screening approach detects all infants with congenital CMV.
Hearing Targeted Screening
Only infants who refer or do not pass their newborn hearing screening are tested for congenital CMV. Because most babies with congenital CMV do not have hearing loss at birth, this type of screening program only identified 7% of babies with congenital CMV.
Expanded Targeted
Infants who are born with certain physical exam findings (e.g. small head size, enlarged liver etc) or who refer/do not pass their newborn hearing screening are tested for congenital CMV. This increases the detection rate to about 15%.