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Postnatally acquired cytomegalovirus infection via breast milk: effects on hearing and development in preterm infants

VOLLMER, BRIGITTE MD; SEIBOLD-WEIGER, KARIN MD; SCHMITZ-SALUE, CHRISTINE MD; HAMPRECHT, KLAUS MD; GOELZ, RANGMAR MD; KRAGELOH-MANN, INGEBORG MD; SPEER, CHRISTIAN P. MD, FRCPE

Pediatric Infectious Disease Journal: April 2004 - Volume 23 - Issue 4 - pp 322-327
Original Studies

Background. In preterm infants there is a high risk of transmission of cytomegalovirus (CMV) via breast milk from seropositive mothers with reactivation of the virus during lactation. There is little information about the long term sequel of early postnatally acquired CMV infection in pre-term infants. This study aimed to investigate whether there was an increased frequency of impaired neurodevelopmental outcome and sensorineural hearing loss in preterm infants with postnatally acquired CMV infection through transmission by CMV-positive breast milk.

Methods. Twenty-two preterm infants [median birth weight, 1020 g (range, 600 to 1870 g); median gestational age, 27.6 weeks (range, 23.6 to 32 weeks] with early postnatally acquired CMV infection by breast-feeding (onset of viruria between Days 23 and 190 postnatally) were compared with 22 CMV-negative preterm infants individually matched for gestational age, birth weight, gender, intracranial hemorrhage and duration of ventilation. At 2 to 4.5 years of age, follow-up assessments were conducted consisting of neurologic examination, neurodevelopmental assessment and detailed audiologic tests.

Results. None of the children had sensorineural hearing loss. There was no difference between the groups with regard to neurologic, speech and language or motor development.

Conclusion. The results of this study suggest that early postnatally acquired CMV infection via CMV-positive breast milk does not have a negative effect on neurodevelopment and hearing in this group of patients. Because we studied a small number of infants, further follow-up studies are warranted in preterm infants with early postnatally acquired CMV infection.

From the Departments of Neonatology (KSW, RG) and Pediatric Neurology (BV, IKM), Children’s Hospital, the Institute of Medical Virology (KH), the Department of Pediatric Audiology, ENT-Hospital (CSS) and the University of Tubingen, Tubingen, Germany; the Children’s Hospital University of Wurzburg, Wurz-burg, Germany (CPS); and the Neurosciences Unit, Institute of Child Health, University College London Medical School, London, UK (BV).

Accepted for publication Dec. 2, 2003.

Address for reprints: Dr. Brigitte Vollmer, Institute of Child Health, Neurosciences Unit, University College London Medical School, Mecklenburgh Square, London WC 1N 2AP, UK. Fax 0044 20 7833 9469; E-mail b.vollmer@ich.ucl.ac.uk.

© 2004 Lippincott Williams & Wilkins, Inc.