Jim Wai-Tim, Chiu Nan-Chang, Ho Che-Sheng, Shu Chyong-Hsin, Chang Jui-Hsing, Hung Han-Yang, Kao Hsin-An, Chang Hung-Yang, Peng Chun-Chih, Yui Bey-Hwa, Chuu Chih-Pin
From the Division of Neonatology (W-TJ, C-HS, J-HC, H-YH, H-AK, C-CP, H-YC), Division of Pediatric Neurology (N-CC, C-SH), Division of Pediatric Infectious Disease (N-CC), Department of Pediatrics, MacKay Children's Hospital; MacKay Junior College of Medicine, Nursing and Management, Taipei (W-TJ, N-CC, B-HY); MacKay Medical College, New Taipei (W-TJ, N-CC, C-SH, C-HS, J-HC, H-YH, H-AK, C-CP); Taiwan Premature Infant Developmental Collaborative Study Group (W-TJ, C-SH, C-HS, J-HC, H-YH, H-AK, C-CP, B-HY); Department of Urology, MacKay Memorial Hospital (B-HY); and Institute of Cellular and System Medicine, National Health Research Institutes, Miaoli County, Taiwan (C-PC).
Medicine (Baltimore). 2015 Oct;94(43):e1835. doi: 10.1097/MD.0000000000001835.
Approximately 15% of preterm infants may develop postnatal cytomegalovirus (CMV) infection from seropositive mothers via breast milk and are at risk for neurological sequelae in childhood. The aims of this study were to assess the effects and outcomes on growth, neurodevelopmental status, and hearing in very low birth weight (VLBW) premature infants with postnatal CMV infection via breast milk at the corrected age of 12 and 24 months.The prospective follow-up study population comprised all living preterm children (n = 55) with a birth weight ≤1500 g and gestational age of ≤35 weeks, who had been participated in our "postnatal CMV infection via breast milk" studies in 2000 and 2009, respectively. The cohort of children was assessed at 12 and 24 months. Clinical outcomes were documented during hospitalization and after discharge. Long-term outcomes included anthropometry, audiologic tests, gross motor quotient, Infant International Battery, and neurodevelopmental outcomes; all were assessed at postcorrected age in 12 and 24 months during follow-up visits.Of the 55 infants enrolled in the study (4 noninfected infants were excluded because their parents did not join this follow-up program later), 14 infants postnatally acquired CMV infection through breast-feeding (infected group) and were compared with 41 infants without CMV infection (control group). No significant differences were observed between the groups with regard to baseline characteristics, clinical outcomes, anthropometry, or psychomotor and mental development on the Bayley scale of infant development. None of the infants had CMV-related death or permanent sensorineural hearing loss.Transmission of CMV from seropositive mother via breast milk to preterm infants does not appear at this time to have major adverse effects on clinical outcomes, growth, neurodevelopmental status, and hearing function at 12 and 24 months corrected age.
约15%的早产儿可能通过母乳从血清学阳性母亲那里感染产后巨细胞病毒（CMV），并面临儿童期神经后遗症的风险。本研究的目的是评估出生体重极低（VLBW）的早产婴儿在12和24个月校正年龄时，因通过母乳感染产后CMV对生长、神经发育状况和听力的影响及结果。前瞻性随访研究人群包括所有存活的早产儿童（n = 55），其出生体重≤1500 g，胎龄≤35周，他们分别于2000年和2009年参与了我们的“通过母乳感染产后CMV”研究。对这组儿童在12和24个月时进行评估。在住院期间和出院后记录临床结果。长期结果包括人体测量、听力测试、大运动商数、婴儿国际电池测试和神经发育结果；所有这些均在随访期间12和24个月校正年龄时进行评估。在纳入研究的55名婴儿中（4名未感染婴儿被排除，因为他们的父母后来未参加此随访项目），14名婴儿通过母乳喂养在出生后获得CMV感染（感染组），并与41名未感染CMV的婴儿（对照组）进行比较。在基线特征、临床结果、人体测量或贝利婴儿发育量表上的精神运动和智力发育方面，两组之间未观察到显著差异。没有婴儿出现与CMV相关的死亡或永久性感音神经性听力损失。血清学阳性母亲通过母乳将CMV传播给早产儿，目前看来在12和24个月校正年龄时对临床结果、生长、神经发育状况和听力功能没有重大不利影响。
