CMV in Newborns

Key points

  • CMV (Cytomegalovirus) is a common virus that can affect people of all ages. More than 50% of adults have been infected with CMV.
  • Most people do not know they have CMV because they have mild symptoms or no symptoms at all.
  • In the United States, 1 in 3 children are infected with CMV by age 5.

You can spread CMV during pregnancy.

If you are pregnant and get infected with CMV, you can pass the virus on to your baby. This is called congenital CMV (cCMV). A cCMV infection in a newborn can cause long term health conditions like cerebral palsy, hearing loss, seizures, and developmental delays. Severe cases of CMV during pregnancy can cause pregnancy loss.

Signs and Symptoms in Healthy Adults

Many adults with CMV do not have any signs or experience symptoms of an infection. Some have minor symptoms, which can include:

  • Fever
  • Sore throat
  • Fatigue
  • Swollen glands

Signs and Symptoms in Newborns

One in 200 babies is born with the cCMV virus. About 1 in 5 babies with cCMV will have long-term health conditions, like hearing differences (hearing loss).

While some babies born with cCMV may not show any signs of an infection at birth, signs may appear later.

Signs at Birth

Some signs and symptoms in babies born with cCMV:

  • Rash
  • Yellow-ish skin or the yellow color around whites of the eyes, or both (jaundice)
  • Small head (microcephaly)
  • Enlarged liver and spleen (hepatosplenomegaly)
  • Seizures
  • Damage to the retina (retinitis)

Long-Term Health Conditions

Some babies born with cCMV may have long-term health conditions, such as:

  • Hearing differences (deaf or hard of hearing)
  • Developmental delays
  • Vision loss
  • Lack of coordination or weakness

Hearing Differences (Hearing Loss) and cCMV

It is common for babies born with cCMV to have a hearing difference also called hearing loss. Some babies with cCMV may not have any signs of hearing issues and may pass their newborn hearing screening. But their hearing status may change later in childhood. This change is called late-onset hearing loss.

It is very important for all babies born with cCMV to be regularly checked by a pediatric audiologist (PDF) and have their hearing tested throughout childhood.

Transmission – How it Spreads

CMV is spread through contact with body fluids, such as:

  • Saliva (spit)
  • Urine (pee)
  • Blood
  • Tears
  • Semen or vaginal fluids
  • Breast or chest milk

Contact with saliva or urine of young children is the biggest cause of CMV infection for pregnant people who are parents, daycare workers, preschool teachers, therapists, and nurses.

Prevention – Ways to Prevent It

You can prevent (PDF) CMV by:

  • Not sharing food, utensils, drinks or straws, especially with young children.
  • Avoiding contact with saliva when kissing a child.
  • Not sharing a toothbrush.
  • Washing hands with soap and water after wiping noses, changing diapers, feeding a child or handling toys.

Testing Newborns for cCMV

Testing for cCMV can be done using a baby’s urine (preferred method), salvia, or blood. This test should be done within 2 to 3 weeks after the baby is born.

Important: If the test for cCMV is done after the baby is 3 weeks old, providers will not know if the baby contracted CMV in-utero (during pregnancy) or after birth.

Testing Pregnant People for CMV

Doctors do not usually test pregnant people for CMV infections. This is because lab tests cannot tell you if your baby will become infected with CMV or have long-term health problems.

Resources

Resources for Parents

American Academy of Pediatrics

Protect Yourself and Your Baby from CMV (PDF) - English Protect Yourself and Your Baby from CMV (PDF) - Chinese Protect Yourself and Your Baby from CMV (PDF) - Russian Protect Yourself and Your Baby from CMV (PDF) - Spanish Protect Yourself and Your Baby from CMV (PDF) - Somali Protect Yourself and Your Baby from CMV (PDF) - Vietnamese

Diagnosis and Management

U.S. Centers for Disease Control and Prevention (CDC)

Comprehensive guidelines for the screening, diagnosis, and management of CMV in pregnant women and newborns.

Clinical Overview of CMV and Congenital CMV Laboratory Testing for CMV and Congenital CMV
National CMV Foundation

The National CMV Foundation works to prevent pregnancy loss, childhood death, and disability due to congenital CMV.

Physician and OB-GYN Resources
The American College of Obstetricians and Gynecologists
Compassionate Conversations: Congenital Cytomegalovirus
Resources for Providers

General

American Academy of Pediatrics
Congenital CMV: Tips for Pediatric Health Care Providers (PDF)

Washington State Department of Health, Early Hearing Detection, Diagnosis, and Intervention (EHDDI) Program

The EHDDI program works with hospitals, doctors, audiologists, and early support providers to make sure that babies identified as deaf or hard of hearing receive essential early support services as soon as possible.

Washington CMV Project

The Washington CMV Project works to influence Washington State to action by promoting specific education about CMV, advocating for statewide newborn CMV screening, and making a difference for the children and families impacted by congenital CMV.

Centers for Disease Control and Prevention (CDC)

CMV Resources

Seattle Children's Hospital

CMV: Cytomegalovirus – Information about CMV Infection (PDF) - English CMV: Cytomegalovirus – Information about CMV Infection (PDF) - Spanish
Support After CMV Diagnosis
Congenital CMV: Support and Next Steps (PDF)
Hearing
Audiology Surveillance in Infants with Congenital CMV (PDF) Newborn Hearing Screening & CMV (PDF)

National CMV Foundation

The National CMV Foundation works to prevent pregnancy loss, childhood death, and disability due to congenital CMV.

About CMV
CMV Awareness Flyers in many different languages Are You Pregnant? (PDF) - Version 1 Are You Pregnant? (PDF) - Version 2 Facts about CMV (PDF) What is Congenital Cytomegalovirus (CMV)? (PDF) - For early support providers

American Academy of Pediatrics: Colorado Chapter

Preventing CMV (YouTube) Special Topic: Congenital CMV Infection