Postnatally acquired cytomegalovirus infection via breast milk: effects on hearing and development in preterm infants

Vollmer, Brigitte; Seibold-Weiger, Karin; Schmitz-Salue, Christine; Hamprecht, Klaus; Goelz, Rangmar; Krägeloh‐Mann, Ingeborg; Speer, Christian P.

doi:10.1097/00006454-200404000-00009

Cited by 138 publications

(122 citation statements)

References 14 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…18,42 These benefits appear to outweigh the risks of severe disease from breast milk-acquired CMV infection in the neonatal period, which has not been definitively associated with the delayed development or sensorineural hearing loss seen with congenital CMV infection. 2,11,13,26,[43][44][45] However, long-term follow-up data on the effects of postnatal CMV infection are limited, with only a small number of infants studied into childhood. One recent study found that the cognitive and motor function scores of VLBW infants with breast milk-acquired CMV infection were within normal ranges when examined at school age but not as high as those of the controls (VLBW infants without CMV infection).…”

Section: Figurementioning

confidence: 99%

Breast Milk–Acquired Cytomegalovirus Infection and Disease in VLBW and Premature Infants

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Very low birth weight (VLBW) and premature infants are at risk for developing postnatal cytomegalovirus (CMV) disease, including CMV-related sepsis-like syndrome (CMV-SLS) for which in the United States are lacking. METHODS: We performed a systematic review and meta-analysis to estimate the pooled proportions (and 95% confidence intervals) of VLBW and premature infants born to CMV-seropositive women with breast milk–acquired CMV infection and CMV-SLS. We combined these proportions with population-based rates of CMV seropositivity, breast milk feeding, VLBW, and prematurity to estimate annual rates of breast milk–acquired CMV infection and CMV-SLS in the United States. RESULTS: In our meta-analysis, among 299 infants fed untreated breast milk, we estimated 19% (11%–32%) acquired CMV infection and 4% (2%–7%) developed CMV-SLS. Assuming these proportions, we estimated a rate of breast milk–acquired CMV infection among VLBW and premature infants in the United States of 6.5% (3.7%–10.9%) and 1.4% (0.7%–2.4%) of CMV-SLS, corresponding to 600 infants with CMV-SLS in 2008. Among 212 infants fed frozen breast milk, our meta-analysis proportions were 13% (7%–24%) for infection and 5% (2%–12%) for CMV-SLS, yielding slightly lower rates of breast milk–acquired CMV infection (4.4%; 2.4%–8.2%) but similar rates of CMV-SLS (1.7%; 0.7%–4.1%). CONCLUSIONS: Breast milk–acquired CMV infection presenting with CMV-SLS is relatively rare. Prospective studies to better define the burden of disease are needed to refine guidelines for feeding breast milk from CMV-seropositive mothers to VLBW and premature infants.

show abstract

Section: Figurementioning

confidence: 99%

Breast Milk–Acquired Cytomegalovirus Infection and Disease in VLBW and Premature Infants

et al. 2013

View full text Add to dashboard Cite

show abstract

“…A recent study suggested less favorable cognitive and motor function outcomes in preterm infants with postnatally acquired CMV infection, as compared with those without CMV infection, 47 but other studies have not demonstrated an increased risk. 48 Future clinical studies are needed to determine whether the appearance of DNAemia in asymptomatic preterm infants is predictive of the development of end-organ disease, and to assess whether there are any short-or long-term benefits to be realized from the use of preemptive antiviral interventions, such as GCV and/or CMV immune globulin, in the absence of clinical evidence of CMV disease.…”

Section: Figurementioning

confidence: 99%

Asymptomatic DNAemia Heralds CMV-Associated NEC: Case Report, Review, and Rationale for Preemption

et al. 2013

View full text Add to dashboard Cite

Human cytomegalovirus (CMV) infection may be acquired in very low birth weight and extremely low birth weight (ELBW) infants from breast milk. The clinical relevance of such infections is uncertain. There is no consensus on whether screening breast milk for CMV, freezing/pasteurizing milk before feeding, or performing virological monitoring on at-risk infants is warranted. We describe an ELBW infant who acquired CMV postnatally from breast milk and developed CMV sepsis syndrome and clinical evidence of necrotizing enterocolitis (NEC) at ∼5 weeks of age. The availability of serial dried blood spots from day of life (DOL) 4 to 21, coincidentally obtained for a metabolic study, provided the novel opportunity to retrospectively test for and quantify the magnitude of CMV DNAemia. DNAemia was present for several weeks before the onset of severe CMV disease, first being noted on DOL 18 and increasing in magnitude daily to 4.8 log10 genomes/mL on DOL 21, approximately 8 days before the onset of abdominal distension and 15 days before the onset of CMV sepsis syndrome and NEC. After surgical resection, supportive care, and ganciclovir therapy, the infant recovered. This case underscores the importance of including CMV infection in the differential diagnosis of sepsis and NEC in premature infants. This case also suggests the value of prospective virological monitoring in at-risk low birth weight and ELBW infants. Future studies should examine the potential utility of preemptive monitoring for, and possibly treatment of, CMV DNAemia in premature infants, which may herald the onset of serious disease.

show abstract

“…Entretanto, visto o pequeno número de crianças avaliadas, estudos de acompanhamento em prematuros com infecções adquiridas no perí-odo pós-natal são necessários 34 .…”

Section: Citomegaliaunclassified

Recommendations for breastfeeding during maternal infections

Lamounier¹,

Moulin²,

Xavier³

2004

J Pediatr (Rio J)

View full text Add to dashboard Cite

Criança e do Adolescente da UFMG.Como citar este artigo: Lamounier JA, Moulin ZS, Xavier CC. Recomendações quanto à amamentação na vigência de infecção materna. J Pediatr (Rio J). 2004;80(5 Supl):S181-S188. AbstractObjective: To make a literature review on breastfeeding and maternal infectious diseases in order to contribute with knowledge and information that can aid the pediatrician to decide upon allowing infected mothers to breastfeed their babies or not. Sources of data:Lilacs and MEDLINE databases were searched for books, technical rules and articles on the issue of breastfeeding and infected mothers.Summary of the findings: Infected lactating mothers can transmit pathogenic agents to their infants. Although breastfeeding protects the child it can also be a dangerous source of infection. Maternal diseases caused by bacteria, virus, fungi and parasites may sometimes be transmitted via human milk. The literature points out that mothers infected with HIV and T-lymphotropic human viruses (type I) should not breastfeed. With other diseases a careful approach should be made, but, in general, breastfeeding is maintained. Conclusion:The mother who is exposed to infectious diseases may transmit pathogenic agents through the human milk, attention should also be made to milk from milk banks. The healthcare provider must take his/her decision upon suspending breastfeeding -or not, what can be distressful, once he/she has a fundamental role in promoting and stimulating breastfeeding.J Pediatr (Rio J). 2004;80(5 Supl):S181-S188: Human milk and infection, mothers infectious illnesses, maternal breast-feeding and infection. ResumoObjetivo: Revisão da literatura com o enfoque de amamentação e doenças infecciosas maternas, no intuito de contribuir com conhecimentos para decisões a serem tomadas pelo profissional de saúde. Fontes de dados:Informações foram obtidas em consultas que incluíram livros-texto, normas técnicas, artigos selecionados por meio de busca na base de dados Lilacs e MEDLINE, além de referências específicas.Síntese dos dados: Nutrizes com doenças infecciosas podem transmitir agentes patogênicos pelo leite materno para a criança. Embora a amamentação confira proteção à criança, ela pode também ser uma importante fonte de infecção. Doenças maternas causadas por vírus, fungos e agentes parasitários podem, em alguns casos, ser transmitidas via leite humano. Para mães com infecções pelo vírus da imunodeficiência humana e vírus T-linfotrópicos humanos tipo I, a recomendação é não amamentar. Nas demais doenças, é necessária uma avaliação cuidadosa, mas, em geral, na maioria dos casos, o aleitamento materno é mantido.Conclusões: Algumas doenças, principalmente as causadas por vírus, podem ser transmitidas durante a amamentação. O profissional de saúde, ao identificar uma nutriz com infecção viral ativa ou outra doença infecciosa, necessita tomar a decisão de suspender ou não a amamentação, o que pode ser um fato angustiante pelo seu papel fundamental na promoção e estímulo ao aleitamento materno.J Pediatr (Rio J). ...

show abstract

Postnatally acquired cytomegalovirus infection via breast milk: effects on hearing and development in preterm infants

Cited by 138 publications

References 14 publications

Breast Milk–Acquired Cytomegalovirus Infection and Disease in VLBW and Premature Infants

Breast Milk–Acquired Cytomegalovirus Infection and Disease in VLBW and Premature Infants

Asymptomatic DNAemia Heralds CMV-Associated NEC: Case Report, Review, and Rationale for Preemption

Recommendations for breastfeeding during maternal infections

Contact Info

Product

Resources

About