Pediatric Department, Tongji Hospital, Tongji Medical Collage, Huazhong University of Science and Technology, Wuhan, China.
BMC Pediatr. 2021 Nov 22;21(1):520. doi: 10.1186/s12887-021-02984-7.
This study aimed to investigate the transmission of cytomegalovirus (CMV) via breast milk in low birth weight (LBW) and premature infants and its effects.
PubMed, Medline, Cochrane Library, and Embase were searched for studies (without language and time restriction) published before March 27, 2020, that examined the effect of CMV transmitted by breast milk on LBW and premature infants. The rates of breast milk-acquired CMV infection, CMV-related symptoms, and CMV-related sepsis-like syndrome (CMV-SLS) in LBW and premature infants were pooled from each study.
Eighteen studies with 1920 LBW and premature infants were included. The pooled CMV infection rate from breast milk for infants fed untreated breast milk was significantly higher than those fed frozen breast milk [19.3, 95% confidence interval (CI) = 11.8-29.9% vs. 13.5, 95% CI = 8.0-22.0%, P < 0.01). Similarly, the pooled CMV infection rate for infants fed untreated breast milk was significantly higher than those with mixed feeding (P < 0.0001). The mixed feeding group had a significantly lower rate of CMV-related symptoms than the other groups (2.4%, P < 0.01).
These findings suggested a higher CMV infection rate in LBW or premature infants fed untreated breast milk than other feeding groups. Studies on the long-term outcomes of CMV infection transmitted from breast milk are needed to address the optimal feeding practice.
本研究旨在探讨巨细胞病毒（CMV）通过母乳在低出生体重（LBW）和早产儿中的传播及其影响。
检索 PubMed、Medline、Cochrane Library 和 Embase，收集截至 2020 年 3 月 27 日前发表的研究（无语言和时间限制），这些研究检查了母乳传播的 CMV 对 LBW 和早产儿的影响。从每项研究中汇总了 LBW 和早产儿通过母乳获得 CMV 感染、CMV 相关症状和 CMV 相关败血性综合征（CMV-SLS）的发生率。
纳入了 18 项研究，共 1920 名 LBW 和早产儿。与食用冷冻母乳的婴儿相比，未处理母乳喂养的婴儿的 CMV 感染率明显更高[19.3%，95%置信区间（CI）=11.8-29.9%比 13.5%，95%CI=8.0-22.0%，P<0.01]。同样，与混合喂养的婴儿相比，未处理母乳喂养的婴儿的 CMV 感染率明显更高（P<0.0001）。混合喂养组的 CMV 相关症状发生率明显低于其他组（2.4%，P<0.01）。
这些发现表明，与其他喂养组相比，未处理母乳喂养的 LBW 或早产儿的 CMV 感染率更高。需要进行研究来探讨母乳传播的 CMV 感染的长期结局，以确定最佳的喂养方式。
