title: Postnatally acquired cytomegalovirus infection in preterm infants: a prospective study on risk factors and cranial ultrasound findings.
abstract: OBJECTIVE
  To study risk factors and cranial ultrasound (cUS) findings in a large cohort of preterm infants, admitted to a neonatal intensive care unit and diagnosed with postnatally acquired cytomegalovirus (CMV) infection.
  
  
  METHODS
  This prospective, observational study was performed from April 2007 until June 2009 among 315 infants born <32 weeks of gestation. Postnatal CMV infection was diagnosed by CMV PCR on urine collected at term-equivalent age. In CMV-positive infants, congenital infection was excluded. The authors compared the clinical and demographic data, feeding pattern and cUS results of infected and non-infected patients. Logistic regression analysis was performed.
  
  
  RESULTS
  In 39 of 315 infants, the diagnosis of postnatal CMV infection has been made. The majority of CMV-infected infants (33/39.85%) did not develop any symptoms of CMV infection. The most important, independent risk factors of postnatal CMV infection were non-native Dutch maternal origin (OR 9.6 (95% CI 4.3 to 21.5)) and breast milk (OR 13.2 (95% CI 1.7 to 104.5)). The risk of infection significantly increased in infants with lower gestational age (GA) (OR 0.7 (95% CI 0.5 to 0.9)). Lenticulostriate vasculopathy (LSV) was significantly more often present in infants with CMV infection (OR 4.1 (95% CI 1.9 to 8.8)).
  
  
  CONCLUSIONS
  Postnatal CMV infection is an asymptomatic infection among preterm infants. Infants with lower GA are at greatest risk of postnatal CMV infection, especially when fed with fresh breast milk from their non-native Dutch mother. LSV not present at birth but confirmed at term-equivalent age can suggest a postnatal CMV infection.
authors.affiliation: Department of Neonatology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Joppe
authors.initials: J
authors.lastname: Nijman
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.forename: Corine
authors.initials: C
authors.lastname: Koopman-Esseboom
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Anton M
authors.initials: AM
authors.lastname: van Loon
authors.forename: Malgorzata A
authors.initials: MA
authors.lastname: Verboon-Maciolek
mesh_terms: D020144:Basal Ganglia Cerebrovascular Disease / Q000000981:diagnostic imaging* / Q000821:virology; D001724:Birth Weight; D001942:Breast Feeding / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000635:transmission; D004453:Echoencephalography / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D018445:Infectious Disease Transmission, Vertical; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human / Q000821:virology; D011446:Prospective Studies; D012307:Risk Factors