Premature infants, especially those born with very low-birth-weight (VLBW), are particularly vulnerable to cytomegalovirus (CMV) infection because of their immature immune systems. CMV infection can cause serious disease and, in severe cases, lead to death.
Two important potential sources of CMV infection in premature infants are blood transfusions and breast milk. Neither source has previously been systematically examined in a large enough study, however, to quantify the specific risks of infection and identify risk factors to help guide prevention strategies.
In a new study published in JAMA Pediatrics, researchers have confirmed that the common strategy of transfusing blood products to VLBW infants that are CMV-seronegative and leukoreduced (blood products with white blood cells removed) effectively prevents transmission of CMV from blood transfusion. Using this transfusion approach, maternal breast milk becomes the primary source of postnatal CMV infection among VLBW infants.
The prospective clinical study enrolled 462 mothers and 539 VLBW infants in three neonatal intensive care units between January 2010 and June 2013. A majority of mothers had a history of CMV infection prior to delivery (CMV sero-prevalence of 76.2 percent). The infants were enrolled within five days of birth, and at the time of enrollment they had not received a blood transfusion. The infants were tested at birth to evaluate for congenital infection, and again at five additional intervals between birth and 90 days, discharge, or death.
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