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Approximately 11% of infants born with congenital <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection may cause severe long\u2010term sequelae, including progressive sensorineural hearing loss and developmental delay in 40\u201358% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection, amniocentesis with <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> performed on amniotic fluid, undertaken after 21\u201322 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital <jats:styled-content style=\"fixed-case\">CMV<\/jats:styled-content> infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed\u2010onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. 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