La gestione dell’ipoacusia neonatale nelle infezioni congenite da CMV. Esperienza decennale.

Introduction - Congenital Cytomegalovirus (cCMV) infection is the main cause of non-hereditary sensorineural hearing loss in children. The Emilia Romagna region has been adopting the newborn hearing screening (NHS) program since 2012. It is based on a two-stage protocol, which is different for healthy babies and the ones admitted to the neonatal intensive care unit. All the children who failed the NHS have undergone urine CMV analysis within the following 14 days since 2013. The present study evaluated the outcomes of the audiological follow up in newborns affected by cCMV infection since the protocol was adopted in Modena University Hospital. Materials and methods - This is a retrospective longitudinal study. Data collected include gestational age, weight at birth, results of NHS test, entity and type of hearing loss, possible use of antiviral therapy, length of audiological follow up, outcomes of treatment. All neonates born between 2013 and 2023 at Modena University hospital were enrolled in the study. Results - During a period of ten years, 32.103 newborns were delivered and 99.4% of them underwent NHS. 38 children were identified as affected by cCMV, 33 of them (86%) had a “pass” result, 4 had a bilaterally “fail” result, 1 a unilateral “fail”. In 7 cases (18%) a diagnosis of hearing loss was made. 1 case (14%) was diagnosed through the NHS test. In 13/36 cases (36%) , excluding those born in 2023, audiological follow up was interrupted at the age of 12 months. Conclusions - This study demonstrated that coupling the cCMV screening and the NHS program is useful for diagnostic purposes as it allows early recognition of asymptomatic cases of hearing loss. The protocol adopted proved to be effective. However, the study evidenced that families of newborns showed lack of compliance and failed in completing an audiological follow up over 12 months.