Article Text

TRANSMISSION OF CYTOMEGALOVIRUS TO VERY LOW BIRTH WEIGHT INFANTS THROUGH BREAST MILK
  1. M G Capretti1,
  2. M Lanari1,
  3. E Tridapalli1,
  4. T Pioli1,
  5. T Lazzarotto2,
  6. L Gabrielli2,
  7. G Piccinin2,
  8. A Chiereghin2,
  9. G Faldella2
  1. 1Department of Preventive Paediatrics and Neonatology, St. Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy,
  2. 2Department of Microbiology and Virology, St. Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy

Abstract

Objective To evaluate the rate and the risk factors of CMV infection in Very Low Birth Weight (VLBW) infants fed with breast milk.

Patients and Methods We evaluated eighty VLBW preterm infants (gestational age (GA) ⩽32 weeks and birth weight <1500 g) and their 68 mothers. All of the infants were breastfed for at least one month. At birth serological test for CMV was performed on maternal blood. Urine samples from each infant and samples of fresh breast milk were collected and processed for CMV culture once a week.

Results Fifty-three mothers (78%) were positive for CMV IgG. In the milk samples CMV was isolated in 21 out of 53 (40%) seropositive mothers. CMV was detected in the urine samples of 9 out of 26 (35%) preterm infants, who were born from 7 virolactia positive mothers. We detected the same genotype gN in the mother’s milk and in the urine of the infected infants. Three of these infants showed a sepsis-like illness with bradycardia, tachypnea and repeated desaturations. The neutropenia was strictly related to CMV infection (P<0.005), as was the detection of an increase in conjugated bilirubin (P<0.05). The use of immunoglobulins with high titre of IgM in newborns with GA<28 ws was protective against CMV infection (P<0.05).

Pre-existing bronchopulmonary dysplasia correlated with symptomatic infection (P<0.05).

Conclusion According to our data, there is no reason not to use or to pasteurize the milk of all the mothers of preterm infants who are CMV seropositive.

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