A summary article sets out the hearing-related recommendations of the 2025 German S2k guideline on CMV in pregnancy and congenital CMV in children. Congenital CMV is the leading infectious cause of congenital and early childhood hearing loss, after genetic causes.
The guideline places universal newborn hearing screening at the centre of detection. If a baby fails the initial screen and the repeat, CMV should be tested promptly by PCR on urine, the reference standard, or saliva, preferably while still in the maternity or paediatric unit and no later than the second to third week of life. Testing beyond that window cannot reliably separate congenital from postnatal infection.
Where congenital CMV is confirmed with symptoms, including isolated hearing loss, antiviral treatment can be offered within the first 30 days of life. The summary states that treatment may lessen, stabilise or prevent progression of hearing loss. Long-term audiological follow-up is needed because loss can progress or appear late.
This is one country's guideline. In India, newborn hearing screening coverage is uneven and CMV PCR is not available everywhere, so the practical step is to build the CMV test into the referral pathway for a failed screen, and to make sure it happens within the window.
- When a baby fails both initial and repeat hearing screening, request CMV PCR on urine or saliva.
- Aim to test before the end of the second to third week of life.
- Refer confirmed cases promptly to paediatrics for antiviral assessment within the first 30 days.
- Arrange long-term audiological follow-up; loss can progress or appear late.
- Agree the pathway between the screening team, paediatrics and ENT in advance.
Why it matters
The window for diagnosis and treatment closes in weeks, and a missed test cannot be repeated later.
Don't overread it
This is a German guideline; check your national and local pathway before adopting it wholesale.
The statistics, in plain English
This summary describes guideline recommendations rather than trial results, so no effect sizes are given; the benefit of antiviral treatment rests on earlier trials not detailed here.
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