Prevention of Cytomegalovirus Transmission via Breast Milk in Extremely Low Birth Weight Infants.
10.3349/ymj.2015.56.4.998
- Author:
Hye Soo YOO
1
;
Se In SUNG
;
Yu Jin JUNG
;
Myung Sook LEE
;
Young Mi HAN
;
So Yoon AHN
;
Yun Sil CHANG
;
Won Soon PARK
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Cytomegalovirus;
infant, extremely low birth weight;
milk, human;
pasteurization;
freezing
- MeSH:
Adult;
Breast Feeding;
Bronchopulmonary Dysplasia;
Cytomegalovirus/*isolation & purification;
Cytomegalovirus Infections/epidemiology/prevention & control/*transmission;
Female;
Gestational Age;
Humans;
Incidence;
Infant;
*Infant, Extremely Low Birth Weight;
Infant, Newborn;
Infectious Disease Transmission, Vertical/*prevention & control;
Male;
Milk, Human/chemistry/*virology;
Polymerase Chain Reaction;
Pregnancy;
Pregnancy Complications, Infectious/diagnosis;
Retrospective Studies;
Risk Factors
- From:Yonsei Medical Journal
2015;56(4):998-1006
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Extremely low birth weight infants (ELBWIs) have a high risk of acquiring cytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs. MATERIALS AND METHODS: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequent positive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcome at corrected age [(CA): 2 years of CMV infection] were analyzed. RESULTS: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and > or =moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestational age and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (> or =moderate) was the only significant adverse outcome associated with this CMV infection. CONCLUSION: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.
