Congenital Cytomegalovirus in Northern Sardinia: universal newborn neonatal hearing screening, audiological surveillance and outcomes.

INTRODUCTION: Cytomegalovirus (CMV) is the most common congenital infection and nongenetic cause of congenital sensorineural hearing loss and only 10% of cases are symptomatic at birth. Hearing loss is present in 50-60% of cases in symptomatic infants and up to 15% in asymptomatic cases. Late-onset cases, whose time of development cannot be predicted, are also reported (Marsico 2017). The study objective was to present outcomes of hearing-targeted CMV screening in North Sardinia. MATERIALS AND METHODS: Audiological findings and history of 44 children affected by congenital CMV, born between 2012 and 2023, and referred to the Audiovestibology Service of the University Hospital of Sassari were systematically analysed. All cases were evaluated through evoked otoacoustic emissions (OAE), diagnostic Auditory Brainstem Responses (ABR) and impedance analysis early in the phase of neonatal hearing screening. Pathological cases were identifyed cases and further diagnostic investigations and rehabilitation were undertaken when indicated. Subsequent audiological surveillance of non-pathological cases at screening was also carried out. RESULTS Of the 44 babies born by mothers positive to cytomegalovirus during pregnancy we report seven cases with hearing loss. In two cases the hearing loss has been bilateral and profound, three babies reported a unilateral hearing loss, one profound the others of moderate entity. Other two cases resulted affected by moderate bilateral SNHL. No cases of late-onset hearing loss were found. CONCLUSION This systematic collection provides an overview of the trend of HL related to congenital CMV in Northern Sardinia and is therefore aimed to stimulate a more frequent and steady program of neonatal screening and audiological long term follow up for this disease.