Babies Born with Congenital Cytomegalovirus (CMV)

When a baby is born with cytomegalovirus (CMV) infection, it is called congenital CMV. Most babies with congenital CMV never show signs or have health problems. However, some babies have health problems at birth or that develop later.

Signs and Symptoms

Some babies with congenital CMV infection have health problems that are apparent at birth or that develop later during infancy or childhood. In the most severe cases, CMV can cause the death of an unborn baby (pregnancy loss).

Some babies with congenital CMV infection have signs at birth. These signs include:

Rash
Jaundice (yellowing of the skin or whites of the eyes)
Microcephaly (small head)
Low birth weight
Hepatosplenomegaly (enlarged liver and spleen)
Seizures
Retinitis (damaged eye retina)

Some babies with signs of congenital CMV infection at birth may have long-term health problems, such as:

Hearing loss
Developmental and motor delay
Vision loss
Microcephaly (small head)
Seizures

Some babies without signs of congenital CMV infection at birth may have hearing loss. Hearing loss may be present at birth or may develop later, even in babies who passed the newborn hearing test.

Transmission

A pregnant woman can pass CMV to her unborn baby. The virus in the woman’s blood can cross through the placenta and infect the baby. This can happen when a pregnant woman is infected with CMV for the first time or is infected with CMV again during pregnancy.

Childcare Providers and Parents of Young Children

People who have frequent contact with young children may be at greater risk of CMV infection because young children are a common source of CMV. By the age of five years, one in three children has been infected with CMV, but usually does not have symptoms. CMV can be present in a child’s body fluids for months after they become infected.

Most people with CMV infection have no symptoms and aren’t aware that they have been infected. A woman who is infected with CMV can pass the virus to her developing baby during pregnancy.

As a parent of a young child or a childcare provider, you may be able to lessen your risk of getting CMV by reducing contact with saliva and urine from babies and young children. The saliva and urine of children with CMV have high amounts of the virus. You can avoid getting a child’s saliva in your mouth by, for example, not sharing food, utensils, or cups with a child. Also, you should wash your hands after changing diapers. These cannot eliminate your risk of getting CMV but may lessen the chances of getting it.

Diagnosis

Congenital CMV infection can be diagnosed by testing a newborn baby’s saliva, urine (preferred specimens), or blood. These specimens must be collected for testing within two to three weeks after the baby is born in order to confirm a diagnosis of congenital CMV infection.

Treatment

For babies with signs of congenital CMV infection at birth, antiviral medications, primarily valganciclovir, may improve hearing and developmental outcomes. Valganciclovir can have serious side effects and has only been studied in babies with signs of congenital CMV infection. There is limited information on the effectiveness of valganciclovir to treat infants with hearing loss alone.