Congenital cytomeglaovirus (cCMV) infection affects up to 1% of all newborns and appears to have a major public health impact. The purpose of this study is to carefully document, the incidence and characteristics at birth and over time of the brain imaging, hearing, vision, growth, development, cognition, achievement, language, gross and fine motor function, and quality of life of children born with virologically confirmed cCMV infection, both symptomatic and asymptomatic at birth, and compare them to uninfected controls. The specific global hypothesis to be tested is cCMV infection and disease, is associated with specific newborn characteristics, and that these newborn characteristics may be predictive of outcomes in later childhood, adolescence and adulthood, and that this knowledge is useful to families, health care, and educational professionals for anticipatory guidance. Through a long term, longitudinal, prospective cohort study of newborns primarily identified through a newborn screening program conducted between 1981 and 1991, this study will perform and analyze serial, age appropriate, standardized tests of vision, hearing, growth, and development, to determine the effects of cCMV on newborn brain imaging by CT scan, hearing and vision;relate newborn findings with long term growth, neurodevelopment, and sensorineural hearing loss (severity, frequency, range, age at onset, unilateral or bilateral, fluctuations, and progressions);correlate sensorineural hearing loss with brain imaging and neurodevelopmental outcome;relate the duration of hearing loss and neurodevelopmental outcome to urine and saliva CMV shedding;analyze viral strain differences or similarities as predictors of outcome;determine the incidence of abnormal cochlear emissions and very high frequency loss (>8,000Hz) to correlate their utility as predictors of sensorineural loss in the mid frequency (up to 4,000 Hz) range;describe the prevalence and outcome of cochlear implantation as a treatment for deafness due to cCMV infection;and to evaluate the positive and negative experiences of families who underwent cCMV newborn screening and follow up to develop appropriate counseling messages for newborn screening programs. PUBLIC HEALTH RELEVANCE: This project will provide information on the long term effects of congenital cytomegalovirus (CMV) infection on growth, development, hearing, and vision, throughout childhood, adolescence, and young adulthood, and the impact of this knowledge on the family. Since congenital CMV affects up to 1% of all newborns, early detection through newborn screening would allow for earlier intervention and improved quality of life for a large proportion of the population.