Epidemiology and economic burden of diagnosed congenital cytomegalovirus disease in France during the first 2 years of life: a retrospective data analysis

Background Congenital cytomegalovirus (cCMV) is the leading infectious cause of birth defects. Recent estimates on cCMV prevalence and burden in France have been scarce. This study assessed the epidemiology, healthcare resource utilization (HRU), direct costs, and cCMV-related clinical outcomes among infants with diagnosed cCMV in France. Methods This retrospective analysis used data from the French National Health Data System (2015–2023). Birth prevalence of diagnosed cCMV was estimated from 2015 to 2023. To assess cCMV burden, infants with a first diagnosis (index date) of cCMV/CMV within 1 month of birth (cases) were matched 1:1 to non-cCMV controls (index date selected randomly among all claims within 1 month of birth) on birth year, sex, region of residence, and index year. All-cause HRU, direct costs (2023 euro [€]), and clinical outcomes were summarized over the first 2 years of life (observation period). Results The prevalence of diagnosed cCMV within 1 month of birth peaked in 2020 and 2023, at 35.04 and 34.77 per 100,000, respectively. The cCMV burden analysis included 1,434 matched pairs of diagnosed cCMV cases and non-cCMV controls. At birth admission, cases had significantly longer hospital stay (mean: 24.6 vs. 6.4 days) and higher costs (mean [median]: €18,759 [€3,804] vs. €3,529 [€1,136]) than controls (both p < 0.001). During the observation period, diagnosed cCMV cases had higher mean number of medical visits than controls (Year 1: 33.7 vs. 18.9; Year 2: 22.6 vs. 12.5), and more cases than controls had ≥ 1 inpatient admission (Year 1: 47.4% vs. 20.3%; Year 2: 25.9% vs. 14.6%) (all p < 0.001). Diagnosed cCMV cases incurred significantly higher direct costs (mean [median] in Year 1: €3,726 [€1,301] vs. €1,870 [€473]; Year 2: €1,759 [€453] vs. €1,019 [€254]) and experienced more potentially cCMV-related sequelae (45.7% vs. 8.4%) than controls (all p < 0.001). Conclusions In France, birth prevalence of diagnosed cCMV trended upward from 2015 to 2023. Infants diagnosed with cCMV had higher HRU and costs, driven by inpatient care, and experienced worse clinical outcomes during the first 2 years of life compared with non-cCMV controls. These results underscore the need for increased early screening of cCMV to mitigate its associated burden.