A new retrospective cohort study examining the impact of Minnesota's first-in-the-nation mandated universal newborn screening for congenital cytomegalovirus (cCMV) shows that universal screening significantly decreased the age at first audiology visit and increased identification of mild hearing loss in infants. The findings, published in Otolaryngology–Head and Neck Surgery, the peer-reviewed journal of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF), add to a growing body of evidence supporting universal cCMV screening programs as a critical public health tool.
Congenital cytomegalovirus is the leading infectious cause of birth defects and the leading non-genetic cause of hearing loss in infants, affecting approximately 1 in every 200 newborns. CMV-related hearing loss can be progressive, with over 55% of both asymptomatic and symptomatic children developing hearing loss after the newborn period. The narrow therapeutic window for antiviral treatment—most effective when initiated within the first month of life—makes early identification through universal screening essential for ensuring timely intervention.
"Our experience in Minnesota shows that universal screening for cCMV enhances our ability to catch mild hearing loss early on in life and has the potential to improve the life of children who are diagnosed with the disease. Our hope is that our experience in Minnesota will guide policymakers in other states as we continue to learn more about cCMV and the best way to screen for and treat this common condition," said Andrew J. Redmann, MD, Assistant Professor in the Department of Otolaryngology–Head and Neck Surgery at the University of Minnesota Medical School and Children's Minnesota.
Researchers examined 132 patients diagnosed with cCMV at Children's Minnesota between 2021 and 2024, comparing outcomes before, during, and after the rollout of universal screening. Key findings include:
- Faster path to hearing evaluation: Infants were seen by audiology significantly sooner—at roughly 25 days of age on average after mandated screening, compared to about 8.5 months before screening existed.
- More mild hearing loss caught: Mandated screening identified four times as many cases of mild hearing loss compared to the prior year, while the number of severe hearing loss diagnoses stayed the same.
- Dramatic increase in diagnoses: The number of cCMV diagnoses jumped from about 3 per year before 2022 to 61 per year once universal screening was in place.
- Proportionally fewer interventions needed: While a similar number of infants overall required treatment such as antiviral medication or hearing devices, these cases represented a smaller share of all positive screens—reflecting a larger population of milder, previously unidentified cases now being captured.
Connecting Research to Academy Advocacy
The findings come as the AAO-HNS continues to advance cCMV screening as one of its top legislative priorities at both the federal and state levels.
"The evidence from Minnesota's pioneering program—and from studies across the country—overwhelmingly supports universal screening," said Rahul K. Shah, MD, MBA, AAO-HNS/F Executive Vice President and CEO. "As the physicians who specialize in the diagnosis and treatment of hearing health conditions, we know that early identification through screening is essential to timely intervention and to the long-term developmental success of children."
Federal Advocacy: The Stop CMV Act
The Stop CMV Act (H.R. 5435/S. 2842) was successfully reintroduced during the first session of the 119th Congress by U.S. Representatives Mike Lawler (R-NY), Greg Landsman (D-OH), and Deborah Ross (D-NC) and U.S. Senators Richard Blumenthal (D-CT), Roger Marshall, MD (R-KS), and Mark Kelly (D-AZ), thanks to the efforts of AAO-HNS working in partnership with other key allies and medical societies. This important legislation would authorize federal funding for cCMV screening programs that improve early detection and intervention of hearing loss in infants.
State-Level Momentum Building in 2026
The Academy's advocacy efforts continue to gain traction across the country:
New York: The Academy submitted a letter to the New York State Legislature in strong support of Assembly bills A.3956 and A.3074, which would establish universal newborn CMV screening and require reporting of positive results to ensure timely referral and coordinated follow-up care.
Oregon: Carol MacArthur, MD, a pediatric otolaryngologist at Oregon Health & Science University, testified on behalf of AAO-HNS before the Oregon Health Authority (OHA) on rules implementing the state's targeted cCMV screening program. Dr. MacArthur urged OHA to include otolaryngology as a first-line referral for infants with confirmed cCMV and emphasized the role of telehealth in reaching rural and underserved families. The OHA issued final rules on December 31.
Vermont: AAO-HNS submitted a letter to the Vermont House Committee on Human Services in strong support of H.533, legislation that would require the Department of Health to add cCMV to the newborn screening panel, provide education for expectant parents and healthcare providers, and create a multidisciplinary advisory committee to support coordinated, evidence-based implementation.
Massachusetts: The Academy submitted testimony in support of H. 4367, which would require universal cCMV screening for all newborns, establish a statewide public education program, and create an advisory committee to guide implementation and ensure equitable access.
Looking ahead: Several additional states are expected to move forward with cCMV screening proposals soon, including Michigan, Illinois, and Vermont.
