Document Detail


Breast milk-acquired cytomegalovirus infection in very low birth weight infants.
MedLine Citation:
PMID:  23016620     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Perinatal transmission of human cytomegalovirus (HCMV) infection in very low birth weight (VLBW) premature infants can lead to serious clinical symptoms and it has ben increasingly recognized that breast milk is the most frequent route of transmission. Breast milk is considered ideal food for newborns because of its nutritional value and anti-infectious components, but it can also be vehicle for viral and bacterial infection. The majority of HCMV seropositive mothers shed the virus into their breast milk and can transmit infection to their offspring. Perinatally acquired infections in full-term neonates are usually asymptomatic without sequelae due to protective maternal HCMV-specific antibodies received during pregnancy. In contrast, VLBW preterm infants are at risk of symptomatic infection with neutropaenia, thrombocytopaenia, sepsis-like syndrome and, less frequently, pneumonia and enteric infection. Postnatally acquired infection seems to spontaneously resolve without altering the clinical outcome. Ganciclovir treatment is restricted to severe symptomatic infections. Preterm infants with a gestational age <30 weeks, or with a birth weight <1000 g, are at greater risk of severe postnatal symptomatic HCMV infection, transmitted via maternal milk. The pasteurization of breast milk entirely eliminates infectivity and prevents virus transmission but alters nutritional and immunological milk properties, and freezing reduces, but does not eradicate, infectivity. Most authors encourage fresh maternal breastfeeding because its beneficial effects outweigh the risk of a transient infection, sequelae-free. Nevertheless, an individual decision based on the condition of health of the infant is important.
Authors:
Giuseppina Lombardi; Francesca Garofoli; Paolo Manzoni; Mauro Stronati
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  25 Suppl 3     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2013-04-03     Revised Date:  2013-10-29    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  57-62     Citation Subset:  IM    
Affiliation:
Neonatal Unit and Neonatal Intensive Care Unit, Maternal-Infant Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. g.lombardi@smatteo.pv.it
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MeSH Terms
Descriptor/Qualifier:
Breast Feeding
Cytomegalovirus / isolation & purification
Cytomegalovirus Infections / diagnosis,  prevention & control,  transmission*
Humans
Infant, Newborn
Infant, Newborn, Diseases
Infant, Very Low Birth Weight
Infectious Disease Transmission, Vertical*
Milk, Human / virology*
Comments/Corrections
Comment In:
J Matern Fetal Neonatal Med. 2013 Oct;26(15):1562   [PMID:  23565920 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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