Transmission du cytomégalovirus par le lait maternel cru aux enfants prématurés : étude épidémiologique pilote

Croly-Labourdette, Séverine; Vallet, Sophie; Gagneur, Arnaud; Gremmo-Féger, G.; Legrand-Quillien, Marie-Christine; Ansquer, Hélène; Jacquemot, L.; Narbonne, Valérie; Lintanf, J.; Collet, Nicolas; Sizun, Jacques

doi:10.1016/j.arcped.2006.03.002

Cited by 17 publications

(9 citation statements)

References 23 publications

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“…Infectious virus and CMV DNA and RNA have been isolated from cellassociated and whey fractions in the breast milk of 40% to 97% of CMVseropositive lactating women. [7][8][9][10][11][12][13][14][15][16][17] In the United States, an estimated 58% of pregnancies occur among CMVseropositive women. 19 Because few data exist on the incidence of breast milk-acquired CMV infection and disease among premature infants, we conducted a systematic review and meta-analysis of studies reporting on postnatal CMV infection and disease presumably acquired via consumption of breast milk among very low birth weight (VLBW) and premature infants born to CMV-seropositive women but uninfected at birth.…”

Section: Resultsmentioning

confidence: 99%

“…One of the 17 studies excluded infants who had received transfusion of blood products. 10 In 10 studies, investigators reported the measures used to prevent CMV transmission from transfused blood products in their institutions, which included transfusion of CMV-IgG seronegative blood products in 5 studies, 8,9,27,28,30 use of leukocyte-depleted blood products in 5 studies, 11,17,26,31 and both in 1 study. 29 In 3 studies, actual samples of blood products administered to infants were tested as part of the study for CMV-DNA and all were negative.…”

Section: Systematic Reviewmentioning

confidence: 99%

“…The 17 studies included in this review were published from 2001 to 2011 (Table 1). [8][9][10][11][12][13][14][15][16][17][25][26][27][28][29][30][31] Nine studies were conducted in Europe (Germany, Italy, France, United Kingdom, and Sweden), 4 in Asia (Japan and Taiwan), 2 in North America (Canada and United States), 1 in South America (Brazil), and 1 in the Middle East (Israel).…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Mothers were tested for IgG and IgM antibodies in 9 studies 8,9,11,[13][14][15]26,28,31 and for IgG antibodies in 4 studies 10,12,25,30 ; 4 studies did not report which serological tests were performed. 16,17,27,29 Studies varied regarding infant inclusion criteria, more commonly specifying a birth weight cutoff of ,1500 g (7 studies) or gestational age ,32 weeks (6 studies) ( Table 1).…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Among infants who were uninfected at birth, postnatal CMV infection was determined through collection of infants' urine weekly, biweekly, or monthly until 8 to 12 weeks of age, and analysis by polymerase chain reaction, 8,9,11,12,14,16,25,26,28,31 viral culture, 8,10,11,13,27,28 or shell vial assay. 10,16,27,29,30 Ofthe17studies,5includedinfantsfedwith untreated breast milk, [8][9][10][11]26 6 included infants fed breast milk that was frozen at temperatures of 2 18°C to 220°C for .24 hours or 72 hours, 12-15,27,28 5 included infants fed untreated breast milk in combination with frozen breast milk and/or pasteurized breast milk from donors, 17,25,[29][30][31] and in 1 study it was unclear whether the infants were given untreated or treated milk. 16 REVIEW ARTICLE (27) 75 ( Overall, 695 infants born to and fed breast milk from CMV-seropositive mothers were identified in the 17 studies, with a median of 38 infants per study (range: 7-90) ( Table 1).…”

Section: Systematic Reviewmentioning

confidence: 99%

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

et al. 2013

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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.

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