Background and aims Despite its major public health impact, there is currently no official screening policy to identify Congenital CMV Infection (CCI) and neonatal testing is based mostly on clinical indications. We aimed to characterise the currently employed clinical indications for CMV testing in neonatal urine samples, and to examine their positive predictive values.
Methods All prenatal and neonatal records of newborns that had urine sample analysed for congenital CMV between 2009 and 2013 at the Virology Laboratory, Hadassah Medical Centre, Jerusalem, Israel, were retrospectively reviewed. The clinical indications for CCI evaluation were obtained, and their positive predictive values were determined.
Results Of 1625 neonates tested, 58 (3.56%) were positive for CCI. The leading clinical indications for testing and their positive predictive values are shown in the Table.
Interestingly, we further identified differences in the distribution and predictive values of the clinical indications between ethnic subpopulations.
Conclusions As suspected maternal CMV infection during pregnancy yielded the highest predictive value and detection rate of CCI, we suggest that in the absence of general neonatal screening policy, prenatal maternal CMV screening should be considered as a primary option for the early identification of CCI. The cost-benefit of this screening approach needs further evaluation.