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出生后通过母乳获得的巨细胞病毒感染:对早产儿听力和发育的影响

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

作者信息

Vollmer Brigitte, Seibold-Weiger Karin, Schmitz-Salue Christine, Hamprecht Klaus, Goelz Rangmar, Krageloh-Mann Ingeborg, Speer Christian P

机构信息

Department of Pediatric Neurology, Children's Hospital, University of Tubingen, Tubingen, Germany.

出版信息

Pediatr Infect Dis J. 2004 Apr;23(4):322-7. doi: 10.1097/00006454-200404000-00009.

Abstract

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.

摘要

背景

对于早产婴儿,巨细胞病毒(CMV)通过血清反应阳性母亲的母乳传播且在哺乳期病毒再激活的风险很高。关于早产婴儿出生后早期获得性CMV感染的长期后遗症的信息很少。本研究旨在调查通过CMV阳性母乳传播而在出生后获得CMV感染的早产婴儿中,神经发育结局受损和感音神经性听力损失的频率是否增加。

方法

将22例通过母乳喂养在出生后早期获得CMV感染(出生后第23天至190天出现病毒尿)的早产婴儿[中位出生体重1020 g(范围600至1870 g);中位胎龄27.6周(范围23.6至32周)]与22例CMV阴性早产婴儿进行个体匹配,匹配因素包括胎龄、出生体重、性别、颅内出血和通气时间。在2至4.5岁时进行随访评估,包括神经学检查、神经发育评估和详细的听力测试。

结果

所有儿童均无感音神经性听力损失。两组在神经、言语和语言或运动发育方面无差异。

结论

本研究结果表明,通过CMV阳性母乳在出生后早期获得的CMV感染对该组患者的神经发育和听力没有负面影响。由于我们研究的婴儿数量较少,对于出生后早期获得CMV感染的早产婴儿,有必要进行进一步的随访研究。

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