Attitudes toward newborn screening for cytomegalovirus infection.

OBJECTIVE: Newborns are not routinely screened for cytomegalovirus (CMV), the leading infectious cause of developmental disability. Congenital CMV satisfies a number of criteria for inclusion in newborn screening, and screening potentially offers benefits. Screening could also introduce harms such as anxiety and unnecessary costs for the families of the substantial proportion of CMV-infected children who never develop CMV-related disabilities. Our objective was to assess attitudes toward newborn screening for CMV. METHODS: We analyzed responses to 5 statements about CMV and newborn screening from 3922 participants in the 2009 HealthStyles survey, a national mail survey designed to include a group similar to the US population with respect to gender, age, race/ethnicity, income, and household size. Two-step cluster analysis was performed to identify clusters of parental attitudes. RESULTS: The majority of respondents strongly or somewhat agreed that they would want to have their newborn tested for CMV even if it was not performed routinely (84%), they had to pay $20 (87%), or CMV-related problems never developed (84%). Nearly half (47%) of them "would worry that the CMV test would lead to unneeded doctor visits and expenses," and 32% "think CMV problems are too rare to worry about." Three clusters of parent respondents were identified on the basis of their attitudes toward CMV screening: "strongly in favor" (31%), "moderately in favor" (49%), and "weakly opposed" (20%). CONCLUSIONS: Among most parents, costs, worry, and anxiety associated with newborn screening for CMV would be acceptable. Although attitudes were generally favorable, a minority of the parents were weakly opposed to newborn screening for CMV.

Estimating the number of births to hepatitis B virus-infected women in 22 states, 2006.

BACKGROUND: Estimating the annual number of births to hepatitis B virus (HBV)-infected women is essential for monitoring efforts to prevent perinatal HBV transmission. We describe a method for estimating births to HBV-infected women in 22 states during 2006. METHODS: The number of births to HBV-infected women was calculated by (1) multiplying the number of US/Canadian-born mothers stratified by US race/ethnicity-specific HBV prevalence estimates, and (2) adding the number of foreign-born mothers stratified by their region of birth and multiplied by region-specific HBV prevalence estimates. RESULTS: Of 2,359,912 births, an estimated 16,608 (0.7%) were to HBV-infected women. Foreign-born women, who represented 25.3% of all mothers, accounted for 80.6% of estimated HBV-infected mothers. Estimated foreign-born HBV-infected mothers were from Southeast Asia (31.2%), East Asia (21.2%), and Africa (13.8%). Non-Hispanic blacks represented 55.1% of US/Canadian-born HBV-infected mothers. Compared with a previous estimate, which considers foreign-born status only for Asian/Pacific Islander mothers, this method estimated an additional 3000 births to HBV-infected women. CONCLUSIONS: Incorporating maternal country of birth and region-specific HBV infection prevalence likely enhances estimation of births to HBV-infected women in the United States. According to our estimate, approximately 10,000 births to HBV-infected women were not identified by state and local health departments in 22 states.