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In this large cohort study, we showed that, even when prenatal imaging is normal, fetuses infected with cytomegalovirus (CMV) during the first trimester of pregnancy are at risk for neurodevelopmental childhood sequelae including deafness and mild developmental delay. What are the clinical implications of this work? Our findings should help clinicians to provide a better evidence-based consultation in pregnancies with first-trimester fetal CMV infection.

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