Connecticut cCMV Mandate Linked to More Diagnoses

An interrupted time series study found that Connecticut’s hearing-targeted newborn screening mandate was associated with a 4.32-fold increase in annual diagnoses of congenital cytomegalovirus (cCMV). Implemented in 2016, the mandate required cCMV testing for newborns who did not pass hearing screening.

Investigators evaluated cCMV diagnoses from 2013 through 2023 within a health system serving approximately 60% of Connecticut’s population. Among 197,177 births, 49 infants met the study criteria for confirmed or probable cCMV. The study modeled annual diagnosis rates before and after implementation of the mandate and tracked long-term audiologic and neurodevelopmental outcomes through June 2025.

Confirmed infection required cytomegalovirus detection by polymerase chain reaction or culture from urine, blood, or cerebrospinal fluid within the first 21 days of life. Probable cases had compatible clinical findings but only presumptive laboratory evidence, such as testing at 22 to 42 days or saliva testing without urine or blood confirmation. The estimated increase in annual diagnoses following the mandate was 4.32-fold (95% CI, 1.09-17.01).

Before the mandate, none of the identified cases were asymptomatic. After implementation, 28% were asymptomatic or had isolated sensorineural hearing loss (SNHL). Among that subgroup, 75% later developed neurodevelopmental sequelae. Hearing worsened in 81% of children who had SNHL at birth, and only 21% of children with follow-up remained without sequelae.

The findings indicate that hearing-targeted screening identified infants with cCMV who otherwise may have been missed while also illustrating the limitations of testing only newborns who do not pass hearing screening. The investigators concluded that many congenital infections likely remain undetected and said the findings support consideration of universal cCMV screening.

Source: Wats A, Araujo BL, Aparicio-Llorente C, et al. Hearing-targeted congenital cytomegalovirus screening: an 11-year experience. Pediatrics. Published online July 20, 2026. doi:10.1542/peds.2025-074229