Universal first-trimester screening for cytomegalovirus (CMV) has long been debated due to lack of effective interventions. With new data showing that treating maternal primary CMV infections with valacyclovir significantly reduces vertical transmission, the paradigm is shifting. A large decision-analytic model (n ≈ 2.87M) demonstrated that universal screening plus valacyclovir prevented nearly 2,900 transmissions, 94 abortions, 19 stillbirths, 11 neonatal deaths, 460 hearing loss cases, and 263 neurodevelopmental disabilities. The strategy proved cost-saving, yielding $242M saved and >3,400 QALYs gained.
Sensitivity analyses confirmed robustness across test performance, drug costs, and maternal utility variations. These findings position universal CMV screening as both clinically impactful and economically favorable, challenging current guidelines. Review the original article online…
