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Perinatal cytomegalovirus infection in very low birth weight infants
Insights
Blood transfusions in very low birth weight (VLBW) infants may increase the risk of perinatal cytomegalovirus (CMV) infection. This prospective study found a higher CMV infection rate in VLBW infants receiving transfusions.
Area of Science:
- Neonatology
- Infectious Diseases
- Transfusion Medicine
Background:
- Improved survival of very low birth weight (VLBW) infants has highlighted specific health challenges.
- Perinatal cytomegalovirus (CMV) infection is a concern in this vulnerable population.
- The role of blood transfusions in perinatal CMV infection requires investigation.
Purpose of the Study:
- To determine the incidence, morbidity, and potential link between blood transfusion and perinatal CMV infection in VLBW infants.
- To compare CMV infection rates between VLBW infants who received blood transfusions and those who did not.
Main Methods:
- Prospective study of 89 VLBW infants without congenital CMV infection.
- Infants categorized into transfusion (TF) and non-transfusion (NT) groups based on clinical need.
- CMV infection assessed in relation to transfusion status, blood donor CMV seropositivity, and maternal antibody levels.
Main Results:
- 38.5% of 52 analyzed VLBW infants developed perinatal CMV infection.
- The transfusion group (TF) showed a significantly higher CMV infection rate (50.0%) compared to the non-transfusion group (NT) (22.7%), p<0.05.
- Infants with lower maternal CMV antibodies at birth had a trend towards higher infection rates, though not statistically significant.
Conclusions:
- Blood transfusion is a significant risk factor for perinatal CMV infection in VLBW infants.
- VLBW infants receiving transfusions are at increased risk, especially when donors are CMV seropositive.
- Further research into CMV screening of blood products for VLBW infants is warranted.
Abstract:
With the improvement in the survival of very low birth weight (VLBW, birth weight less than 1500gm) infants, problems specifically related to this weight group infants have been revealed. To define the incidence, morbidity and the possible role of blood transfusion of perinatally acquired cytomegalovirus (CMV) infection, 89 VLBW infants who had no evidence of congenital CMV infection were enrolled in a prospective study. 94% of the 82 infants tested had transplacental CMV IgG antibody at birth. According to the need of blood transfusion, Infants were divided into two groups: transfusion group (TF group) and nontransfusion group (NT group). Fifty two cases finished the study, thirty cases in the TF group, twenty-two cases in the NT group, and were subjected to the final analysis. Infants in this two groups were compatible in birth weight, gestational age, sex and mode of delivery. Infants in the TF group were sicker and had higher incidence of morbidity. Infants in the TF group received fresh blood from walking donors for small amount of blood transfusion. Each infant received an average of 52.3 +/- 42.6 ml blood from 2.3 +/- 1.3 donors. Ninety-five percent of the blood donors were CMV seropositive. Twenty out of the 52 (38.5%) VLBW infants developed perinatal CMV infection. Higher rate of perinatal CMV infection was found in the TF group (50.0%), comparing with the NT group (22.7%), p less than 0.05. More infants with low maternal antibodies at birth got perinatal CMV infection than infants with high maternal antibodies (47.6 vs 20%). Yet, the difference didn't reach statistical significance (p greater than 0.05, less than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)