[Chances and challenges in the prevention and treatment of early childhood hearing loss: the AWMF guideline on congenital CMV infection].

After genetic causes, congenital cytomegalovirus (cCMV) infection is the leading infectious cause of congenital and early childhood hearing loss. The 2025 German S2k guideline on prevention, diagnosis, and treatment of CMV infection in pregnant women and congenital CMV infection in neonates and children published by the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF; 093-003 [24]) provides corresponding recommendations and summarizes the current evidence. Hygiene counseling of pregnant women, targeted diagnostic testing during pregnancy and in neonates, and antiviral therapeutic options are important measures for prevention and treatment of congenital CMV infection. Universal newborn hearing screening (UNHS) is decisive for the diagnosis of congenital hearing loss. If abnormal results are revealed in the initial and follow-up testing, polymerase chain reaction (PCR) analysis of CMV DNA in urine (gold standard) or saliva should be performed immediately-as it should be in the case of other symptoms-preferably in the maternity or pediatric hospital and certainly not later than in the second to third week of life. In the case of symptomatic congenital CMV infection, causal treatment of congenital hearing loss can be offered as early as during the first 30 days of life-both for clinically symptomatic infants and for those with isolated hearing loss. Treatment may reduce the severity of hearing loss, stabilize hearing, or prevent progression. Long-term aftercare is essential to recognize progression or a late onset of hearing loss and to ensure adequate management. In addition to dissemination of these guideline recommendations, interdisciplinary cooperation-particularly between the maternity and neonatal departments performing UNHS and otorhinolaryngology and pediatric audiology departments-is essential.