Breast Milk-Acquired Cytomegalovirus Infection and Disease in Very Low Birth Weight and Premature Infants

Details

• Alternative Title:
  Pediatrics
• Personal Author:
  Lanzieri, Tatiana M. ; Dollard, Sheila C. ; Josephson, Cassandra D. ; Schmid, D. Scott ; Bialek, Stephanie R.
• Description:
  Introduction
  
  Very low birth weight (VLBW) and premature infants are at risk of developing postnatal cytomegalovirus (CMV) disease, including CMV-related sepsis-like syndrome (CMV-SLS). Estimates of breast milk-acquired CMV infection and disease among these infants 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%–6.8%) 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.
  
  
• Subjects:
  Article Breast Milk Cytomegalovirus Cytomegalovirus Infections Female Humans Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Infectious Disease Transmission, Vertical Milk, Human Premature Infant Sepsis-like Syndrome Seroepidemiologic Studies Very Low Birth Weight Infant

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• Source:
  Pediatrics. 131(6):e1937-e1945.
• Pubmed ID:
  23713111
• Pubmed Central ID:
  PMC4850548
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  131
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:facee82f6904a4b0eb030c5a18063e2086b9cc5c524a5d4f3f5513d0f811667e
• Download URL:
  https://stacks.cdc.gov/view/cdc/39161/cdc_39161_DS1.pdf
• File Type:
  [PDF - 262.07 KB ]