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Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
[Screening for cytomegalovirus infection in very low birth weight infants]
E Álvarez Domínguez1, J Figueras Aloy, F Botet Mussons
1Servicio de Neonatología, Hospital Clínic, Universitat de Barcelona, Barcelona, España.
Insights
Cytomegalovirus (CMV) infections are common in very low birth weight (VLBW) infants. Early diagnosis and breast milk screening can help manage congenital and acquired CMV infections in this vulnerable population.
Area of Science:
- Neonatal infectious diseases
- Virology
- Perinatology
Context:
- Cytomegalovirus (CMV) is a significant cause of congenital and acquired vertical transmission in humans.
- Very low birth weight (VLBW) infants are particularly susceptible to severe outcomes from CMV infection.
- Understanding the clinical relevance of CMV in VLBW infants is crucial for effective management.
Purpose:
- To determine the clinical relevance of Cytomegalovirus (CMV) infection in very low birth weight (VLBW) infants.
- To evaluate a screening protocol for diagnosing CMV infection in preterm infants.
- To assess the impact of congenital versus acquired CMV infection on VLBW infants.
Summary:
- A study of 342 preterm infants (≤31 weeks gestation, ≤1500g birth weight) found 15.5% were infected with CMV.
- Congenital CMV infection was associated with lower birth weight, intrauterine growth restriction, thrombocytopenia, and cerebral anomalies.
- Acquired CMV infection was linked to a higher incidence of late sepsis.
Impact:
- The study highlights the high frequency of CMV infections in VLBW infants.
- The implemented screening protocol aids in diagnosing CMV infections.
- The protocol may help prevent acquired CMV infections through targeted breast milk management.
Introduction:
Cytomegalovirus (CMV) is the most common congenital and acquired vertically transmitted viral infection in humans. The aim of the study is to determine the clinical relevance of this infection in very low birth weight (VLBW) infants in our area.
Patients And Method:
Preterm infants (gestational age ≤ 31 weeks) with a birth weight ≤ 1500g treated between March 2006 and December 2010 were included. They underwent the screening protocol for diagnosing CMV infection. CMV serology was performed on the mothers. When it was positive, their breast milk was frozen at -20°C for 72hours from the 7th day of birth. At 5 weeks, the urine of the newborn was tested for CMV-DNA. In case of a positive result, CMV-DNA was performed in breast milk and in the dry blood sample from metabolic screening.
Results:
A total of 342 preterm infants were studied, with 53 (15.5%) infected by CMV: 8 (2.3%) with congenital infection, 35 (10.2%) with acquired infection, and 10 (2.9%) in which it was impossible to determine precisely. IgM-CMV+in the mother was found in two congenital infections and two acquired infections. Newborns affected by congenital CMV infection showed a lower birth weight, more intrauterine growth restriction, thrombopenia, need for platelet transfusions, early sepsis (including clinical sepsis), and cerebral ultrasound anomalies. Late sepsis was more frequent in cases of acquired CMV infection.
Conclusions:
Congenital or acquired CMV infections are frequent in VLBW infants, and our protocol enables them to be diagnosed and probably prevents some acquired CMV infections by selecting which patients should freeze the breast milk.
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