Postnatal cytomegalovirus infection in extremely preterm infants receiving raw mother’s own milk: clinical course and neurodevelopment at two years

Abstract

Objective. To investigate neonatal manifestations and neurological outcomes after postnatal cytomegalovirus (CMV) infection in extremely preterm infants receiving raw mother’s own milk.

Methods. This was a retrospective analysis of 45 lactating mothers and their 53 infants born ≤ 28 weeks gestational age. Maternal serologies and screening for CMV in infants were obtained. CMV-positive and CMV-negative groups were compared regarding clinical course, raw mother’s own milk intake, as well as growth, neurological, and hearing outcomes until 24 months corrected age.

Results. Maternal seroprevalence was 90%. CMV viruria occurred at a median age of 33.4 weeks in 10 infants, all born to CMV-seropositive mothers. CMV-positive infants were more exposed to daily raw mother’s own milk (70% vs. 28%; P = .02). Five infants with a history of prolonged ventilation and systemic corticosteroids increased their ventilator needs concurrently with CMV infection. The rates of bronchopulmonary dysplasia, necrotizing enterocolitis and retinopathy were similar in both groups. There was no fatal outcome among CMV-positive infants. However, hospital stay was prolonged by 26 days on average (P = .02). At 24 months, 7 CMV-positive infants and 22 CMV-negative infants scored similarly on Bayley-III scales. Sensorineural hearing loss was not detected after CMV infection.

Interpretation. Postnatal CMV infection in extremely preterm infants had no impact on hearing and neurodevelopment within the first 2 years of life. However, postnatal CMV infection might worsen respiratory status and increase length of hospital stay.