Lihong RAN, Lei BAO. Infection status and follow-up observation for acquiring cytomegalovirus infection via breast milk among premature infants[J]. Journal of Third Military Medical University, 2018, 40(10): 939-944.
DOI:
Lihong RAN, Lei BAO. Infection status and follow-up observation for acquiring cytomegalovirus infection via breast milk among premature infants[J]. Journal of Third Military Medical University, 2018, 40(10): 939-944. DOI: 10.16016/j.1000-5404.201710077.
Infection status and follow-up observation for acquiring cytomegalovirus infection via breast milk among premature infants
To investigate the infection status of breast milk transmitted cytomegalovirus (CMV) and short-term prognosis among premature infants when their mothers' milk were positive to CMV.
Methods
2
A total of 113 premature infants admitted in our department from September 2015 to December 2016 were enrolled in this study. There were 37 infected infants with breast milk transmitted CMV and 76 control infants. The incidence
clinical manifestations
and short-term outcome of 6 months were analyzed.
Results
2
Postnatal CMV infection was observed in 32.7 % (37/113) of premature infants who were fed fresh breast milk. CMV infection was symptomatic in 51.4% (19/37) of the infected cases. When compared with the control infants
these infected infants had significantly higher incidence rates of thrombocytopenia
aminotransferase elevation
hepatomegaly
and neonatal necrotizing enterocolitis (NEC) [18.9% (7/37)
vs
1.3% (1/76)
29.7% (11/37)
vs
13.2% (10/76)
10.8% (4/37)
vs
0.0% (0/76)
27.0% (10
/37)
vs
9.2% (7/76)
P
<
0.05
]
and obviously shorter gestational age and lower birth weight [31.3 (25.6~35.7)
vs
33.4 (31.1~ 36.3) weeks
1.5±0.5
vs
1.9±0.3 kg
P
<
0.05
]
. During the 6 months' follow up
no statistical differences were found in growth status
neurodevelopmental outcome and hearing impairment between the 2 groups (
P
>
0.05).
Conclusion
2
The infants fed with CMV positive breast milk have higher incidence of breast milk-acquired CMV infection
SHAO X M, YE H M, QIU X S. Practice of neonatology[M]. 4th ed.Beijing: People's Medical Publishing House, 2011: 310-311.
LEE H, PARK H, HA E, et al . Effect of breastfeeding duration on cognitive development in infants: 3-year follow-up study[J ] . J Korean Med Sci, 2016, 31(4): 579-584. DOI: 10.3346/jkms.2016.31.4.579.
GINOVART G, GICH I, VERD S. Human milk feeding protects very low-birth-weight infants from retinopathy of prematurity: a pre-post cohort analysis[J]. J Matern Fetal Neonatal Med, 2016, 29(23): 3790-3795. DOI: 10.3109/14767058.2016.1145648.
ZHOU J, SHUKLA VV, JOHN D, et al . Human milk feeding as a protective factor for retinopathy of prematurity: a meta-analysis[J ] . Pediatrics, 2015, 136(6): e1576-e1586. DOI: 10.1542/peds.2015-2372.
BINNS C, LEE M, LOW W Y. The long-term public health benefits of breastfeeding[J]. Asia Pac J Public Health, 2016, 28(1): 7-14. DOI: 10.1177/1010539515624964.
The group of infectious diseases and gastroenterology, Chinese pediatric society, Chinese medical association.The diagnosis scheme of cytomegalovirus infection[J]. Chin J Pediatr, 1999, 37(7): 441. DOI: 10.3760/j.issn: 0578-1310.1999.07.015.
Coordinating study group of nine cities on the physical grouth and develoment of children, Capital institute of pediatrics.A national survey on growth of children under 7 years of age in nine cities off china, 2005[J].Chin J Pediatr, 2007, 45(8): 609-614. DOI: 10.3760/j.issn: 0578-1310.2007.08.012.
JOSEPHSON C D, CALIENDO A M, EASLEY K A, et al . Blood transfusion and breast milk transmission of cytomegalovirus in very low-birth-weight infants: a prospective cohort study[J ] . JAMA Pediatr, 2014, 168(11): 1054-1062. DOI: 10.1001/jamapediatrics.2014.1360.
KURATH S, HALWACHS-BAUMANN G, M LLER W, et al . Transmission of cytomegalovirus via breast milk to the prematurely born infant: a systematic review[J ] . Clin Microbiol Infect, 2010, 16(8): 1172-1178. DOI: 10.1111/j.1469-0691.2010.03140.x.
MASCHMANN J, HAMPRECHT K, DIETZ K, et al . Cytomegalovirus infection of extremely low-birth weight infants via breast milk[J ] . Clin Infect Dis, 2001, 33(12): 1998-2003. DOI: 10.1086/324345.
MEIER J, LIENICKE U, TSCHIRCH E, et al . Human cytomegalovirus reactivation during lactation and mother-to-child transmission in preterm infants[J ] . J Clin Microbiol, 2005, 43(3): 1318-1324. DOI: 10.1128/JCM.43.3.1318-1324.2005.
JIM W T, CHIU N C, HO C S, et al . Outcome of preterm infants with postnatal cytomegalovirus infection via breast milk: a two-year prospective follow-up study[J ] . Medicine (Baltimore), 2015, 94(43): e1835. DOI: 10.1097/MD.0000000000001835.
MEHLER K, OBERTHUER A, LANG-ROTH R, et al . High rate of symptomatic cytomegalovirus infection in extremely low gestational age preterm infants of 22-24 weeks' gestation after transmission via breast milk[J ] . Neonatology, 2014, 105(1): 27-32. DOI: 10.1159/000355306.
BUXMANN H, MILJAK A, FISCHER D, et al . Incidence and clinical outcome of cytomegalovirus transmission via breast milk in preterm infants weeks[J ] . Acta Paediatr, 2009, 98(2): 270-276. DOI: 10.1111/j.1651-2227.2008.01105.x.
ALARCÓN A A, BAQUERO-ARTIGAO F. Review and guidelines on the prevention, diagnosis and treatment of post-natal cytomegalovirus infection.[J]. Anales de Pediatria, 2010(1): 52-51. DOI: 10.1016/j.anpedi.2010.05.024.
TENGSUPAKUL S, BIRGE N D, BENDEL C M, et al . Asymptomatic DNAemia heralds CMV-associated NEC: case report, review, and rationale for preemption[J ] . Pediatrics, 2 013, 132(5): e1428-e1434. DOI: 10.1542/peds.2013-0087.
YOO H S, SUNG S I, JUNG Y J, et al . Prevention of cytomegalovirus transmission via breast milk in extremely low birth weight infants[J ] . Yonsei Med J, 2015, 56(4): 998-1006. DOI: 10.3349/ymj.2015.56.4.998..
BEVOT A, HAMPRECHT K, KR GELOH-MANN I, et al . Long-term outcome in preterm children with human cytomegalovirus infection transmitted via breast milk[J ] . Acta Paediatr, 2012, 101(4): e167-e172. DOI: 10.1111/j.1651-2227.2011.02538.x.
HUANG L, XIONG F, LI J, et al . An analysis of hearing screening test results in 2291 premature infants of Chinese population[J ] . Int J Pediatr Otorhinolaryngol, 2017, 95(4): 15-19. DOI: 10.1016/j.ijporl.2017.01.027.
XIA Y F, LIU C Q, LI H X, et al . Investigation of risk factors for hearing impairment in premature infants[J ] . Chin J Contemporary Pediatr, 2013, 15(12): 1050-1053.
LANZIERI T M, DOLLARD S C, JOSEPHSON C D, et al . Breast milk-acquired cytomegalovirus infection and disease in VLBW andpremature infants[J ] . Pediatrics, 2013, 131(6): e1937-e1945. DOI: 10.1542/peds.2013-0076.
CHIAVARINI M, BRAGETTI P, SENSINI A, et al . Breastfeeding and transmission of cytomegalovirus to preterm infants. Case report and kinetic of CMV-DNA in breast milk[J ] . Ital J Pediatr, 2011, 37(1): 6. DOI: 10.1186/1824-7288-37-6.
HAYASHI S, KIMURA H, OSHIRO M, et al . Transmission of cytomegalovirus via breast milk in extremely premature infants[J ] . J Perinatol, 2011, 31(6): 440-445. DOI: 10.1038/jp.2010.150..
Follow-up and evaluation of anorectal malformation children with rectovestibular fistula after surgical treatment
Clinical characteristics of asthma and COPD overlap syndrome: report of 240 cases
Microbial screening and therapeutic strategies for tentative diagnosis of Pneumocystsis carinii pneumonia and/or cytomegalovirus pneumonia
Prognostic value and clinical significance of high-amplitude slow wave changes in video electroencephalogram of preterm infants between 28 and 30 weeks of conceptional age
Clinical value of etiological analysis and endoscopic treatment of recurrent acute pancreatitis
Related Author
Xiaoping JIANG
Yimao ZHANG
Xiaolong XIE
Bo XIANG
Yang WU
唐小婷
马千里
王长征
Related Institution
Department of Pediatric Surgery, West China Hospital of Sichuan University