title: Case-control study of symptoms and neonatal outcome of human milk-transmitted cytomegalovirus infection in premature infants.
abstract: OBJECTIVE
  Preterm infants are at risk of acquiring human cytomegalovirus (CMV) infection through breast milk transmission, possibly leading to serious symptoms, as suggested by previous studies. Over a period of 8.5 years, we compared infants infected postnatally with CMV with noninfected controls to determine whether CMV infection transmitted through breast milk poses serious acute risks.
  
  
  METHODS
  CMV monitoring included maternal serologic testing and biweekly viral culture and polymerase chain reaction in breast milk and infant urine. Clinical and laboratory test findings were assessed retrospectively in infected infants and controls matched for gestational age during the initial hospital stay.
  
  
  RESULTS
  Forty CMV-infected infants met the study criteria. They had lower minimal platelet and neutrophil counts and a higher frequency of C-reactive protein (CRP) elevations to 10 to 20 mg/L than their matched controls (P < or = .001). But no association of CMV infection with bronchopulmonary dysplasia, necrotizing enterocolitis, growth, or CRP elevations to > 20 mg/L was found. Cholestasis appeared in 3 infants in the CMV-infected group, but disappeared within 10 weeks.
  
  
  CONCLUSIONS
  Neonatal symptoms related to postnatal CMV infection were transient and had no affect on neonatal outcome in these infants, in contrast with uncontrolled reports. Whether withholding or pasteurizing breast milk is warranted, however, depends on long-term outcome.
authors.affiliation: Department of Neonatology, University Children's Hospital and Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital, Tuebingen, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Neuberger
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamprecht
authors.forename: Matthias
authors.initials: M
authors.lastname: Vochem
authors.forename: Jens
authors.initials: J
authors.lastname: Maschmann
authors.forename: Christian P
authors.initials: CP
authors.lastname: Speer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahn
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
authors.forename: Rangmar
authors.initials: R
authors.lastname: Goelz
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002779:Cholestasis / Q000175:diagnosis; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000635:transmission*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical; D007442:Intubation, Intratracheal; D008297:Male; D008895:Milk, Human / Q000821:virology*; D009504:Neutrophils / Q000378:metabolism; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000378:metabolism
chemical_list: D002097:C-Reactive Protein