Maternal and Neonatal Screening for Congenital Cytomegalovirus Infection: Proactive Measures and Healthcare Optimization

Abstract

Background: Congenital cytomegalovirus is the most common viral congenital viral infection, affecting up to 2.4% of live births worldwide. It can lead to long-term disabilities, including sensorineural hearing loss (SNHL), intellectual disabilities and motor impairments. Despite its prevalence, Congenital cytomegalovirus remains under-diagnosed due to the asymptomatic nature of most infections and the absence of standardised screening programmes. Studies show that universal neonatal screening using saliva or urine samples could improve early detection, but implementation remains inconsistent. This study systematically evaluates early congenital cytomegalovirus screening practices, their effectiveness in reducing transmission, and their impact on child health outcomes.
Methods: This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and employs the Population, Intervention, Comparator and Outcome (PICO) framework. The study population includes pregnant women and neonates undergoing routine Congenital cytomegalovirus screening. Data were collected from major medical databases (PubMed, Embase, Web of Science and Scopus), covering research from 2001 to 2024. A structured data extraction tool, based on the Cochrane Handbook was used to analyse the studies for relevant outcomes.
Results: The findings revealed that early detection and intervention for congenital cytomegalovirus reduces mother to child transmissibility of the virus, as well as infant sensorineural hearing loss and developmental delays in children. Evidence from countries with established screening programmes indicates that incorporating congenital cytomegalovirus testing into routine perinatal and neonatal care enhances early detection rates. Besides evidence of a knowledge-gap among healthcare providers regarding standardised screening protocols, the study outcomes indicated that early screening improves health outcomes while generates long-term cost savings. However, disparities in screening practices across regions result in inconsistent implementation and unequal health outcomes.
Conclusions: Between 10% – 15% of infected infants develop long-term cognitive impairment, which has a significant long-term psychosocial impact on society. Therefore, routine perinatal screening improves health outcomes and leads to long-term cost savings. This study addresses knowledge gaps in existing screening protocols, offering evidence-based recommendations to improve maternal and neonatal health outcomes. These outcomes are essential for shaping public health policies and promoting standardised screening measures, thereby reducing the burden of congenital cytomegalovirus infections.