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February 1, 2021

Newborn Dried Blood Spot Testing for Congenital Cytomegalovirus Screening: The Little Engine That Could

Author Affiliations
  • 1Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine and Infectious Diseases Service, Texas Children’s Hospital, Houston
JAMA Pediatr. 2021;175(3):e205445. doi:10.1001/jamapediatrics.2020.5445

In the article by Dollard et al,1 the preliminary results of a sentinel newborn screening program for congenital cytomegalovirus (CMV) comparing detection of CMV DNA in newborn dried blood spots (NBDBS) using enhanced, more sensitive DNA extraction and polymerase chain reaction (PCR) methods are reported. They compared NBDBS testing with CMV DNA detection in saliva swabs in a newborn screening study involving more than 12 000 newborns of a projected 25 000 enrolled in a multicenter Minnesota study. In this study, Dollard et al1 demonstrate a prevalence of 0.45% of congenital CMV and show high analytical sensitivity (combined: sensitivity, 85.7%; 95% CI, 74.3%-92.6%; University of Minnesota laboratory: sensitivity, 73.2%; 95% CI, 60.4%-83.0%; US Centers for Disease Control and Prevention laboratory: sensitivity, 76.8%; 95% CI, 64.2%-85.9%) for NBDBS CMV DNA detection. Prior studies involving retrospective diagnosis of symptomatic newborns have shown a similar sensitivity of 62% to 95%, but when NBDBS were used for large-scale, prospective newborn screening for congenital CMV, similar to the study by Dollard et al,1 sensitivities as low as 37% were reported.2,3 By using enhanced PCR methods, Dollard et al1 have rekindled the hope that NBDBS testing may be a viable method for large-scale, universal newborn screening for congenital CMV.

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