Outcome of Preterm Infants With Postnatal Cytomegalovirus Infection

Abstract

In this cohort study, postnatal cytomegalovirus infection in preterm children did not have an adverse effect on neurodevelopment within the first 6 years of life.

Prevalence of Congenital CMV Infection and Antiviral Therapy in Very-Low-Birth-Weight Infants: Observations of the German Neonatal Network

“…In a few studies on postnatal CMV infection other authors found postnatal CMV infection associated with BPD [14,20] suspecting a direct or indirect effect of the virus on the lung tissue [14]. These findings remain conflicting, since other authors could not find an association of BPD and CMV [5]. We further observed increased rates of surgery requiring ROP, but could not find an association of ROP and antiviral therapy in our logistic regression analysis.…”

“…Transmission occurs via untreated breast milk [6]. Most commonly associated symptoms are respiratory decompensation and thrombocytopenia [20] and infection seems to have an effect on respiratory long-term morbidity [14,20], but no effect on neurological long-term outcome [5].…”

Postnatally acquired cytomegalovirus infection in extremely premature infants: how best to manage?

“…Neurodevelopmental assessment to the age of 6 years was performed in 49 infected infants, with no difference in the first 3 years of life identified. Although pCMV-infected children had significantly lower verbal IQ scores at the age of 6 years, multiple regression analysis indicated no impact of CMV status but significant influence of maternal education and ethnicity 31. A single-centre, case-controlled study in 19 CMV-infected infants showed subtle, in parts statistically significant, differences in motor and cognitive outcomes 35.…”

“…Multiple population-based cohort studies have shown no association between pCMV infection and sensorineural hearing loss 31–33…”

Controversies in Breastfeeding

“…Regarding the debate over the long-term cognitive consequences of postnatal CMV infection through human milk in preterm infants, a recent large prospective study conducted in the Netherlands involving 356 preterm infants with a gestational age of <32 weeks followed-up until age 6 years reported that neurodevelopmental problems, including hearing loss, are unlikely ( 47 ). As pasteurization or freezing reduces the biological and immunological protective value of breastmilk against necrotizing enterocolitis ( 48 ), the study concluded that these processes may not be justified ( 47 ).…”