Loss In Infants Research Articles

Risk patterns associated with transient hearing impairment and permanent hearing loss in infants born very preterm: A retrospective study.

To determine the risk patterns associated with transient hearing impairment (THI) and permanent hearing loss (PHL) of infants born very preterm who failed hearing screenings. We enrolled 646 infants (347 males, 299 females) born at no more than 30 weeks' gestation between 2006 and 2020 who received auditory brainstem response screening at term-equivalent age. Audiological examinations of infants who failed the screening revealed THI, when hearing normalized, or PHL, defined as a persistent unilateral or bilateral hearing threshold above20 dB. Principal component analysis (PCA) was used to characterize risk patterns. Among the 646 infants, 584 (90.4%) had normal hearing, 42 (6.5%) had THI, and 20 (3.1%) had PHL. Compared with the group with normal hearing, the THI and PHL groups had significantly higher rates of neurodevelopmental impairment at 24 months corrected age. PCA of risk patterns showed the THI group and especially the PHL group had more severe haemodynamic and respiratory instability. Moreover, severe intraventricular haemorrhage (IVH) was also a risk for PHL. Propensity score matching revealed an association of haemodynamic and respiratory instability with PHL. In infants born preterm, the severity and duration of haemodynamic and respiratory instability are risk patterns for both THI and PHL; severe IVH is an additional risk for PHL. Neurodevelopmental delay was more common in infants born preterm who failed hearing screening. Principal component analysis revealed the risk patterns associated with hearing impairment. Haemodynamic-respiratory instability was associated with transient and permanent hearing impairment outcomes. Severe haemodynamic-respiratory instability and intraventricular haemorrhage was associated with permanent hearing loss.

Targeted screening for congenital cytomegalovirus: A micro-costing analysis.

We aimed to determine the cost and potential cost-savings of delivering a targeted congenital cytomegalovirus (cCMV) screening programme through a universal newborn hearing screening (UNHS) programme to detect cCMV-related hearing loss in infants from Victoria, Australia. We completed a micro-costing analysis from a health-care perspective using data from a targeted cCMV screening programme piloted between June 2019 and March 2020. The programme involved collection of saliva samples to test for cCMV in infants who: received a 'refer' result on their second newborn hearing screen; were aged 21 days or less; and born at one of four maternity hospitals in Victoria, Australia. All costs to complete targeted cCMV screening were recorded in Australian 2020 dollars. Potential costs and benefits of adding targeted cCMV screening to the pre-existing UNHS programme were compared to when no screening was available up to 18 years to determine the likely cost or cost savings. The cost of adding targeted cCMV screening to Victoria's UNHS is $202 per infant screened. The total cost per positive case identified is $21 456. The overall cost of adding targeted salivary cCMV screening at the point of a second 'refer' result on the UNHS programme in Victoria's four largest hospitals is estimated to be $28 966 for the first year. Targeted screening for cCMV provides families the opportunity to detect and, if appropriate, treat cCMV in the first month of life in line with current recommendations. It falls within the range between cost neutral and cost saving.

Using the Eat Sleep Console Model to Promote Optimal Care and Outcomes for Infants With Neonatal Abstinence Syndrome: A Nurse-Driven, Multidisciplinary Initiative.

A nurse led a team of providers in a quality improvement (QI) project to positively impact inpatient care and outcomes for infants with neonatal abstinence syndrome (NAS). The Eat Sleep Console (ESC) model was implemented to promote rooming-in and family-centered care as part of a nonpharmacological treatment approach. To compare the ESC model with the traditional Finnegan treatment approach to describe differences in infants' pharmacotherapy use (morphine), length of stay (LOS), weight loss, consumption of mother's own milk by any feeding method within 24 hours of discharge, Neonatal Intensive Care Unit (NICU) use, and Pediatric Unit utilization. The QI project was conducted at a single hospital site with more than 1700 deliveries per year in the Midwestern United States. A comparative effectiveness study design was used to evaluate the ESC model. The ESC model impacted care and outcomes for infants with NAS, contributing to a significant reduction in morphine treatment, decrease in LOS among morphine-treated infants, increase in weight loss in infants who did not require morphine treatment, less NICU use, and greater Pediatric Unit utilization. A nonsignificant increase was found in the number of infants who consumed their mother's own milk by any feeding method in the 24-hour period prior to discharge. Results may be helpful for hospitals striving to optimize care for infants exposed to opioids, using assessments of eating, sleeping, and consoling to guide individualized treatment decisions and to reduce morphine use.

A study of hearing loss in infants using brain stem evoked response audiometry

<p class="abstract"><strong>Background:</strong> Hearing is necessary to learn languages and speech and to develop cognitive skills. Unfortunately, many children with severe hearing loss from birth are not diagnosed until 21/2-3 years. of age. Implementing high-risk neonatal screening, detecting hearing loss before 3 months, and intervention before 6 months will result in a better speech performance of neonates.</p><p class="abstract"><strong>Methods:</strong> Detailed history taking and general and ear, nose and throat (ENT) examination were done to rule out external ear and middle ear pathology. Brainstem evoked response audiometry (BERA) was done in a dust-free, sound-proof, airconditioned room. Feed was given 10–15 min before the procedure. Syrup pedichloryl 20 mg/kg was given to sedate the baby half an hour before the procedure. Intelligent hearing system BERA instrument was used. The study included a total of 60 infants. 30 were in the high-risk group and 30 were in the normal group. There were 14 males and 16 females in each group. </p><p class="abstract"><strong>Results:</strong> 21 infants had hearing loss out of the 30 infants in the high-risk group on initial screening. On doing a repeat BERA after 3 mins on the affected infants, 3 were detected to have normal hearing, i.e., 18 out of 30 infants were affected. All the infants in the normal or no risk factor group had normal hearing.</p><p class="abstract"><strong>Conclusions:</strong> The present study emphasizes the importance of using ABR as a screening tool for the detection of hearing impairment at an early stage which would have otherwise go unnoticed for about 2-3 years. Since it is an objective test, it is useful in the early identification of hearing loss.</p><p> </p>

The Effect of High Humidity Environments on Very Low Birth Weight Preterm Infants: A Systematic Review

The scholarly evidence on the timing and practice of interventional care administered to preterm infants in high-humidity environments is unclear. This makes evaluating the prognosis of preterm infants with comorbidities difficult and means that clinical medical staff lack clear guidelines for care. This systematic review was designed to explore the prognostic effects of interventions for comorbidities performed on very low birthweight preterm infants in high humidity environments to provide an empirical basis for developing related clinical-care guidelines. An electronic database was searched for all relevant documents published between 1930 and September 2021. The keywords used were "premature infants" OR "very low weight premature infants" OR "very low weight premature infants" AND "humidity", and the target groups were premature infants weighing ≤ 1,500 grams or delivered at ≤ 34 weeks of gestation. The timing and practice of interventions in high humidity environments and the occurrence and prognosis of related comorbidities were explored. The main findings cover the issues of body weight, total water intake, electrolytes, urine output, insensitivity water loss, infection, common complications, and mortality in preterm infants. After reviewing the methods, quality, and efficacy of the research in the identified studies, 9 articles were selected for integrated synthesis. Recommendations for the use of high humidity with infants delivered at ≤ 30 weeks of gestation or at birth weights ≤ 1,000 grams were integrated. An environment with a relative humidity of 70%-80% should be used during the first postpartum week and 50%-60% during the second postpartum week. The recommended total duration of use of a high-humidity environment is two weeks to avoid delaying the development of the stratum corneum. Physiological indicators shown to exhibit significant improvement under this regimen include reduced total water intake, increased urine output, and a lower incidence of hypernatremia. The appropriate timing and practice of high humidity intervention were integrated in this study. It is hoped that this review provides an evidence-based clinical practice guideline for preterm infant care.

A Retrospective Evaluation to Assess Reliability of Electrophysiological Methods for Diagnosis of Hearing Loss in Infants.

Background: An electrophysiological investigation with auditory brainstem response (ABR), round window electrocochleography (RW-ECoG), and electrical-ABR (E-ABR) was performed in children with suspected hearing loss with the purpose of early diagnosis and treatment. The effectiveness of the electrophysiological measures as diagnostic tools was assessed in this study. Methods: In this retrospective case series with chart review, 790 children below 3 years of age with suspected profound hearing loss were tested with impedance audiometry and underwent electrophysiological investigation (ABR, RW-ECoG, and E-ABR). All implanted cases underwent pure-tone audiometry (PTA) of the non-implanted ear at least 5 years after surgery for a long-term assessment of the reliability of the protocol. Results: Two hundred and fourteen children showed bilateral severe-to-profound hearing loss. In 56 children with either ABR thresholds between 70 and 90 dB nHL or no response, RW-ECoG showed thresholds below 70 dB nHL. In the 21 infants with bilateral profound sensorineural hearing loss receiving a unilateral cochlear implant, no statistically significant differences were found in auditory thresholds in the non-implanted ear between electrophysiological measures and PTA at the last follow-up (p > 0.05). Eight implanted children showed residual hearing below 2000 Hz worse than 100 dB nHL and 2 children showed pantonal residual hearing worse than 100 dB nHL (p > 0.05). Conclusion: The audiological evaluation of infants with a comprehensive protocol is highly reliable. RW-ECoG provided a better definition of hearing thresholds, while E-ABR added useful information in cases of auditory nerve deficiency.

Urine podocyte mRNA loss in preterm infants and related perinatal risk factors

BackgroundPreterm birth has been identified as a risk factor for development of long-term chronic kidney disease. Podocyte loss has been reported to contribute to this process in preterm animal models. However, details about podocyte loss in preterm infants and related perinatal risk factors have not been well clarified.MethodsForty full-term infants and 106 preterm infants were enrolled. Urine samples were collected from full-term infants within 4–7 days of birth and preterm infants at 37–40 weeks of corrected age. Levels of urine podocin mRNA, urine protein (UP), and urine microalbumin (UMA) were measured, and the relationship between these markers was evaluated. Clinical information in these infants was collected, and potential correlates that may lead to increased podocyte loss during the perinatal period were identified using linear regression analysis.ResultsUrine podocyte loss indicated by the urine podocin mRNA to creatinine ratio (UpodCR) was higher in preterm infants than in full-term infants. UpodCR was correlated with the levels of UP and UMA. Multiple linear regression analysis also showed that lower gestational age (GA) at birth and small for gestational age (SGA) were high risk factors for urine podocyte loss.ConclusionsIncreasing urine podocyte loss was identified in preterm infants. Moreover, perinatal factors were associated with podocyte loss and may be a potential direction for comprehensive research and intervention in this field.Graphical A higher resolution version of the Graphical abstract is available as Supplementary information

EPH65 The Public Health Impact of Routine Vaccination in 16-40-Year-Old Females for the Prevention of Cytomegalovirus and Congenital Cytomegalovirus in the United States

Cytomegalovirus (CMV) infection in healthy individuals is often mild or asymptomatic; however, a pregnant woman can pass CMV to her newborn, resulting in congenital cytomegalovirus (cCMV), the major infectious cause of sensorineural hearing loss and neurodevelopmental abnormalities in infants born in developed countries. There are no vaccines currently available to prevent CMV.

The Effectiveness of Early Initiation of Breastfeeding (IMD) in Reducing the Incidence of Hypothermia in Newborn at Ngimbang Lamongan Hospital in 2021

Early initiation of breastfeeding affects the body temperature of newborns, because heat loss in infants is four times greater than in adults. This action as a life saver, early initiation of breastfeeding can also save 22 percent of babies who die before the age of one month. The purpose of this study was to determine the effect of early initiation of breastfeeding on changes in body temperature in newborns. The design of this study used a quasi-experimental approach with pretest and posttest approaches. The sampling method is by accidental sampling. Data were collected by means of observation, and analyzed using a computerized Wilcoxon test with a significance level of P-Sign <0.05. The results showed that almost 90% of newborns before early initiation of breastfeeding experienced a decrease in body temperature and after early initiation of breastfeeding only 10% experienced low body temperature. From the results of statistical testing, the results obtained with Z = -4.243 and P value = 0.000. The conclusion of this study is that there is an effect of early initiation of breastfeeding on changes in body temperature of newborns at Ngimbang Lamongan Hospital in 2021. Looking at the results of this study, it is hoped that midwives will continue to provide early initiation of breastfeeding to every newborn to prevent hypothermia.

CHIRP AUDITORY STEADY -STATE RESPONSE AS A HEARING SCREENING TOOL IN HIGH- RISK INFANTS

Background:Newborn hearing screening with automated procedures usually uses broad band stimuli, such as click. Studies using the Auditory Steady-State Response (ASSR) that used specific frequency chirps named narrow band CE-chirps have shown obvious diagnostic results. Objective:To assess the value of the binaural multi-frequency chirp ASSR as a hearing screening tool. To compare chirp ASSR and click ABR as a tool for early diagnosis of hearing loss in infants with risk factors for hearing loss.Methodology: Two groups of infants were studied, group I (28 infants with risk factors) with one or more risk factor for permanent hearing loss, group II (ten infants without risk factors). Their age ranges from one to six months. Assessment of middle ear pressure using immittancemetry, and hearing threshold estimation using Click ABR and Chirp ASSR were done. Results: When comparing hearing threshold of [group (I) infants with risk factors], and [group (II) infants without risk factors] it was found that there was no statistically significant difference when hearing was evaluated by using click ABR or Chirp ASSR.By comparing average ASSR (Average thresholds of1000, 2000 and 4000 HZ) threshold with ABR threshold, there was no statistically significant difference. There was high positive correlation between ABR threshold and average ASSR. Conclusion: Chirp ASSR can be used for assessment of hearing thresholds in infants with the same accuracy of Click ABR thresholds, with more advantage perceived by ASSR in the form of frequency specific threshold estimation. The binaural multi-frequency chirp ASSR can be used as a hearing screening tool.

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Access to Pediatric Audiological Evaluation Facilities: Urgent Needs and Why They Matter

Risk factors for hearing loss in infants: a systematic review

Risk factors for hearing loss in infants: a systematic review

Toward improved measurement of infant bone conduction auditory brainstem responses

Newborn hearing screening has led to improved detection and treatment of hearing loss (HL) in infants and young children, supporting improved communication outcomes in early childhood and beyond. However, current screening protocols are not equally sensitive to all forms of HL, limiting diagnostic accuracy and, ultimately, identification of appropriate treatment options. Correspondingly, treatment outcomes in children with HL remain quite variable. One fundamental and persistent challenge is the assessment of bone conduction hearing, which is essential to differentiate conductive versus sensorineural pathology. Whereas hearing via air conduction can be effectively assessed using the auditory brainstem response (ABR), a noninvasive electrophysiologic measure, bone conduction ABR measurements suffer from comparatively poor signal quality (including significant stimulus artifact), transducer acoustic output limitations, and generally lower test-retest reliability. Here we evaluated the prospective benefits of measuring infant bone conduction ABRs using a modified bone conduction transducer designed to reduce stimulus artifact and thereby improve measurement quality. Measurements obtained using a standard bone conduction transducer were compared on several dimensions to measurements obtained using the modified transducer. Improved bone conduction measurement tools are expected to support improved detection and classification of conductive and mixed HL, leading to improved treatment outcomes for this important patient population.

A Randomized Pilot Trial Assessing the Role of Human Fibrinogen Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants Undergoing Cardiopulmonary Bypass

The objective of this study was to determine whether treatment with human fibrinogen concentrate decreases the need for component blood therapy and blood loss in neonate and infant patients undergoing cardiopulmonary bypass. Pediatric patients (N = 30) undergoing elective cardiac surgery were randomized to receive human fibrinogen concentrate or placebo following cardiopulmonary bypass termination. The primary endpoint was the amount of cryoprecipitate administered. Secondary endpoints included estimated blood loss during the 24 h post-surgery; perioperative blood product transfusion; effects of fibrinogen infusion on global hemostasis, measured by laboratory testing and rotational thromboelastometry; and adverse events. No clinically significant differences were identified in baseline characteristics between groups. A significantly lower volume of cryoprecipitate was administered to the treatment group during the perioperative period [median (interquartile range) 0.0 (0.0–0.0) cc/kg vs 12.0 (8.2–14.3) cc/kg; P < 0.0001] versus placebo. No difference was observed between treatment groups in blood loss, laboratory coagulation tests, use of other blood components, or incidence of adverse events. FIBTEM amplitude of maximum clot firmness values was significantly higher among patients treated with human fibrinogen concentrate versus placebo (P ≤ 0.0001). No significant differences were observed in post-drug HEPTEM, INTEM, and EXTEM results. Human fibrinogen concentrate (70 mg/kg) administered after the termination of cardiopulmonary bypass reduced the need for transfusion with cryoprecipitate in a neonate and infant patient population.ClinicalTrials.gov identifier: NCT02822599.

Application of auditory brainstem response to different types of hearing loss in infants

Objective:The aim of this study is to analyze the variation characteristics of ABR wave latency and wave interval in different functional states of middle ear and different hearing levels, and to explore the value of ABR detection method in hearing assessment of infants. Methods:A total of 670 children were enrolled in the Pediatric Hearing Diagnosis and Treatment Center of the Department of Otolaryngology head and Neck Surgery, Beijing Children's Hospital, Capital Medical University from May 2020 to April 2021. According to the hearing test results, they were divided into group A normal group（632 ears）. Group B consisted of normal middle ear function and abnormal hearing（157 ears）, further divided into mild hearing loss subgroup（49 ears）, moderate hearing loss subgroup（47 ears） and severe to very severe hearing loss subgroup（61 ears）. Group C was a group with abnormal middle ear function（551 ears）, which was further divided into normal hearing subgroup（307 ears）, mild hearing loss subgroup（110 ears）, moderate hearing loss subgroup（107 ears） and severe to very severe hearing loss subgroup（27 ears）. The differences of Ⅰ, Ⅲ, Ⅴ Wave Latency, Ⅰ-Ⅲ, Ⅰ-Ⅴ wave interval between subgroups B and C and Group A, and between subgroups B and C were analyzed. Results:When the stimulus intensity was 80 dB nHL, there was no significant difference in ABR latency and wave interval between group B and group A, and there was no significant difference between group B and group A（P>0.05）, nor between the two groups（P>0.05）. In the subgroup of severe to very severe hearing loss, some ABRⅠ, Ⅲ and Ⅴwaves could not be elicited, only Ⅲ and Ⅴ waves were elicited from 4 ears and Ⅴ waves were elicited from 7 ears. The mean latency of 11 ear Ⅲ and Ⅴ waves was （5.20±0.44） ms and （6.80±0.75） ms, respectively, which was longer than that of mild and moderate hearing loss subgroups. Compared with group A, the latency of normal hearing subgroup in group C was significantly prolonged only for wave Ⅰ, and the latency of wave I, Ⅲ and Ⅴin other subgroups was significantly prolonged（P<0.01）. In terms of Ⅰ-Ⅲ and Ⅰ-Ⅴ wave intervals, there was no significant difference between group C and group A in normal hearing subgroup and mild loss subgroup. The subgroup of moderate hearing loss and the subgroup of severe to very severe hearing loss were significantly shorter than the group A（P<0.01）. Compared with the normal group, the latency of Ⅰ, Ⅲ and Ⅴ waves in group C were significantly longer（P<0.01）. The latency of wave Ⅰ, in the moderate hearing loss group was significantly longer than that in the mild hearing loss group（P<0.001）. The latency of each wave in severe to very severe hearing loss subgroup was significantly longer than that in mild and moderate hearing loss subgroup（P<0.001）. There was no difference between mild hearing loss subgroup and normal hearing subgroup（P>0.05）. The subgroup of moderate hearing loss and severe to very severe hearing loss were significantly shorter than the subgroup of normal hearing and the subgroup of mild hearing loss, and there was a significant difference between the two groups（P<0.01）. Conclusion:In sensorineural hearing loss, mild and moderate hearing loss had no significant effect on the latency and interwave period of ABR. The latency of each wave in severe to very severe hearing loss cannot be elicited normally or only Ⅲ and Ⅴ waves can be elicited, and it is significantly prolonged. The latency of ABR Ⅰwave was significantly prolonged when middle ear function was abnormal. The latency of each wave was significantly prolonged when middle ear function was abnormal and hearing was abnormal. When hearing loss reaches a certain degree, the interwave period is shortened significantly. Therefore, for mild to moderate hearing loss, the prolonged latency of ABRⅠ wave is of certain value for the qualitative diagnosis of hearing loss, and the prolonged latency of ABR Ⅰwave is of significance for judging middle ear dysfunction in infants.

Diagnostic value of IT-MAIS scores by logistic regression and ROC curve in predicting the degree of hearing loss in infants and toddlers aged 0-36 months

Objective:This study is inorder to compare the early prelingual auditory development trajectory of infants and toddlers with normal hearing and different degrees of hearing loss, and to explore the value of the Infant-Toddler Meaningful Auditory Integration Scale （IT-MAIS） scores in the diagnosis of hearing loss severity in infants and toddlers aged 0-36 months. Methods:Eight hundred and forty-two cases of infant-toddler from March 2009 to March 2021 were selected as participants, including 231 cases with normal hearing and 611 cases with hearing loss. The IT-MAIS scores of participants with different degrees of hearing loss were fitted with nonlinear regression with age. By respectively constructing three logistic regression models of IT-MAIS total scores, perception scores, discrimination scores and evaluation age, the ROC curve was drawn to evaluate the diagnostic efficacy. Results:The IT-MAIS scores of children with mild, moderate, severe, and profound hearing loss participants changes with age are similar to the development of infants with normal hearing, and they all increase with age. And the more severe the hearing loss, the slower the growth rate, and the lower the peak value that can be reached. The logistic model constructed by combining IT-MAIS total score and evaluation age is the best to distinguish mild and above, moderate and above, severe and above, and profound hearing loss, whose AUC are 0.827, 0.889, 0.948, 0.946. The diagnostic efficiency is the best for infant-toddlers with profound hearing loss, with a sensitivity of 89.6% and a specificity of 88.4%. The more severe the hearing loss, the higher the discrimination accuracy of IT-MAIS and the better the diagnostic efficiency. Conclusion:The logistic model based on the IT-MAIS scale and the ROC curve method have a good efficiency in the diagnosis of hearing loss severity in infants and toddlers aged 0-36 months. When the child cannot cooperate with behavioral audiometry, the results of behavioral audiometry are unreliable, and there is no electrophysiological condition, the IT-MAIS scale is expected to evaluate the degree of infants' hearing loss as an auxiliary tool. It can understand the children's auditory function state more and provides a basis for the subsequent formulation of rehabilitation intervention strategies with certain clinical application value.

Likely Impact of the COVID-19 Pandemic on Newborn Hearing Screening and Follow-up Services in the United States in 2020.

This perspective aims to highlight aspects of the Early Hearing Detection and Intervention (EHDI) newborn hearing screening and follow-up processes that were impacted by the COVID-19 pandemic and considers factors that likely impacted follow-up after failing newborn hearing screening among infants born in the United States during 2020. Efforts to minimize the potential impact of missed or delayed identification of hearing loss in infants and young children will also be discussed to help guide future program improvement activities.

Risk Factors for Early Weight Loss in Breastfed and Term Newborns

Objective: Newborns lose some of their birth weight before hospital discharge. This loss is accepted as “physiological” up to 5-7%. Infants with weight loss over this range may receive undue formula supplementation. Formula supplementation disrupts exclusive breastfeeding, does not have the benefits of mother’s milk, and may cause low breastfeeding success in the long run. Identification of the risk factors affecting infant weight loss percentage in the few days following the birth will increase exclusive breastfeeding success. The aim of this study is to identify the risk factors that cause early weight loss in newborns before hospital discharge. Material and Methods: Weight loss in infants born between January 1, 2011, and December 31, 2014, at Vehbi Koç Foundation American Hospital was evaluated retrospectively. The hospital records of 3812 babies who completed the inclusion criteria were included in the study. The variables yielding significant results in binary tables were further evaluated by “Multivariate Logistic Regression”. Results: Delivering via caesarean section, primiparity, early term gestational week, older maternal age and female gender of the infant were statistically significant risk factors for early weight loss in newborns. Conclusion: To increase the success of breastfeeding in babies who are exclusively breastfed, the mother-infant pair identified with risk factors that contribute to infant weight loss must be closely monitored. Breastfeeding counselling should be repeated, and breastfeeding should be supported. Suggested intervention list is created aligned with the findings to assist mothers in risk management.

Congenital Cytomegalovirus Infections Mother-Newborn Pair Study in Southern Ethiopia.

Introduction Congenital cytomegalovirus (cCMV) is a common cause of neurodevelopmental delays and sensorineural hearing loss of infants, yet the prevalence of cCMV and the associated factors in Ethiopia are not studied. Hence, this study was to assess the prevalence and associated factors of cCMV in Southern Ethiopia. Methodology. A mother-newborn pair cross-sectional study was conducted at Hawassa University Comprehensive and Specialized Hospital, Ethiopia. Newborn's saliva sample was tested for cCMV using Alethia CMV molecular assay. Mothers' serum was tested serologically for anti-CMV IgM and IgG by EUROIMMUN ELISA. Pregnant women responded to a questionnaire about their previous and current obstetric history and sociodemographic characteristics. The chi-square (χ2) test and independent-sample t-test were used to determine the associations between infections and possible risk factors; then, potential variables were screened for multivariable analysis. Results A total of 593 mother-newborn pairs were assessed. CMV was detected in 14 of 593 newborn saliva swabs (2.4%; 95% CI 1.2–3.7). As assessed by CMV IgM-positive results, maternal CMV seropositivity was 8.3% (49/593); thus, the rate of mother-to-child transmission of CMV was 28% (14/49) among CMV IgM-positive women. Congenital CMV infection was significantly associated with maternal exposure through nursery school children in the household, women sharing a feeding cup with children, and any of the detected curable STIs during pregnancy. Birth weight was negatively associated with CMV infection. Maternal age, gravidity, level of education, and sharing of children feeding utensils were not associated with cCMV infection. Conclusion A high rate of cCMV infection in the absence of awareness demands further in-depth investigation in Ethiopia. Thus, policymakers must take appropriate action through the antenatal care system for prevention strategies and put in place a constant health education and awareness creation of pregnant women about the causes of infection and hygienic measures.

Clinicians' Views and Experiences with Offering and Returning Results from Exome Sequencing to Parents of Infants with Hearing Loss.

Exome sequencing (ES) is an effective method for identifying the genetic cause of hearing loss in infants diagnosed through newborn hearing screening programs. ES has the potential to be integrated into routine clinical care, yet little is known about the experiences of clinicians offering this test to families. To address this gap, clinicians involved in a clinical study using ES to identify the cause of infants’ hearing loss were interviewed to explore their experiences with offering and returning results to parents. Interview transcripts were analysed using inductive content analysis. Twelve clinicians participated: seven genetic counsellors, four clinical geneticists, and one paediatrician. Most clinicians were supportive of offering ES to infants with hearing loss, primarily because results may inform the child’s clinical management. However, some expressed concerns, questioning the utility of this information, particularly for isolated hearing loss. Clinicians had differing views regarding the optimal time to offer ES to families; while some felt that families can manage everything at once, others recommended delaying testing until parents have come to terms with their child’s diagnosis. These findings show the complexity involved in determining how ES should be offered to families following the diagnosis of a child with hearing loss, particularly with regards to when testing is suggested.