Incidence, Risk Factors, and Morbidity of Acquired Postnatal Cytomegalovirus Infection Among Preterm Infants Fed Maternal Milk in a Highly Seropositive Population

Incidence, Risk Factors, and Morbidity of Acquired Postnatal Cytomegalovirus Infection Among Preterm Infants Fed Maternal Milk in a Highly Seropositive Population

Author Martins-Celini, Fabia Pereira Google Scholar
Yamamoto, Aparecida Yulie Google Scholar
Passos, Debora Manzione Google Scholar
do Nascimento, Suely Dornellas Google Scholar
Lima, Edineia Vaciloto Google Scholar
Di Giovanni, Celia Mara Google Scholar
Sevilla Quadrado, Ellen Regina Google Scholar
Barta, Roberta Google Scholar
Aragon, Davi Casale Google Scholar
do Prado, Seila Israel Google Scholar
Almeida, Maria Fernanda Branco de Autor UNIFESP Google Scholar
Mussi-Pinhata, Marisa Marcia Google Scholar
Abstract Preterm infants born to mothers with high cytomegalovirus (CMV) seroprevalence are as frequently infected as those born to mothers with lower seroprevalence. CMV infection contributes to an uneven clinical course, severe stages of retinopathy of prematurity (ROP), and even death.Methods.aEuro integral A cohort of 188 a parts per thousand currency sign30-week-old infants was monitored from admission to discharge. CMV-DNA, hematology, liver enzymes, neutralizing antibodies, and CMV-DNA-lactia were tested periodically. Results.aEuro integral Mothers of 157 infants (83.5%) were CMV-seropositive. A total of 24/157 (15.3%) infants became infected (95% confidence interval [CI], 9.8-22.6), particularly those of lower gestational age (GA

relative risk [RR], 2.32

95% CI, 1.01-5.34 for 23-26 weeks). Low (< 1:64) neutralizing antibody titers were similarly detected in CMV-infected and uninfected infants. Mean DNA-lactia in mothers was higher in CMV-infected than in uninfected infants (5.34 log vs 4.60 log). Clinical findings suggestive of CMV disease were similar in CMV-infected (50.0%) and CMV-uninfected (51.1%) infants. Although transitory, > 2 laboratory test abnormalities occurred more frequently among CMV-infected (39.1%) than CMV-uninfected (2.1%) infants. More severe stages of retinopathy of prematurity (ROP) were found among CMV-infected infants (adjusted RR, 2.51

95% CI, 1.07-5.91). Although deaths were more frequent among infected infants, none of the deaths could be directly attributed to CMV. Conclusions.aEuro integral Postnatal CMV infection acquired by exposure to raw maternal milk is very frequent among extremely premature newborns, being facilitated by high DNA-lactia and lower GA, regardless of maternally acquired neutralizing antibody levels. The association with advanced stages of ROP is a concern and needs to be further explored in larger studies.
Keywords cytomegalovirus
human milk
postnatal infection
prematurity
xmlui.dri2xhtml.METS-1.0.item-coverage Cary
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 2007/07315-6
Date 2016
Published in Clinical Infectious Diseases. Cary, v. 63, n. 7, p. 929-936, 2016.
ISSN 1058-4838 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press Inc
Extent 929-936
Origin http://dx.doi.org/10.1093/cid/ciw394
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000386041100019
URI https://repositorio.unifesp.br/handle/11600/56983

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