Cytomegalovirus Secretion in Breast Milk of Mothers Delivering at ≤ 32 Weeks' Gestation: A Prospective Observational...

Preterm neonates are at risk of symptomatic postnatal cytomegalovirus (pCMV) acquired from CMV-positive breast milk intake. This study ascertained the proportion of mothers delivering at ≤ 32 weeks' gestation with CMV lactatia.

This prospective study included mother-infant dyads delivered at ≤ 32 weeks' gestation. CMV was detected in breast milk by quantitative DNA PCR. For the proportion of neonates who tested positive for CMV DNA (urine or blood) at 4-6 weeks of age, clinical outcomes were also measured. CMV load > 42.5 copies/mL was considered positive. Virologic (breast milk and infant blood/urine CMV PCR) and clinical correlates were evaluated.

Out of the 93 mothers whose fresh breast milk was tested, 50 (53.7%, 95%CI 42.3, 55.9%) were positive for CMV. Out of 43 infants who were tested for CMV in blood or urine at 4-6 weeks of postnatal age, 10 (23%, 95%CI 18.1, 28.6%) turned positive. Significant differences were noted in the duration of respiratory support [47.5 (30, 73) vs 7 (3, 30) days; P = 0.002] and hospital stay [86.5 (80, 98) vs 51 (31, 65) days, P < 0.001] between CMV positive and negative infants. CMV-positive status was not an independent risk factor for bronchopulmonary dysplasia [aOR 5.3 (95%CI 0.9-31.0)] and retinopathy of prematurity requiring therapy [aOR 17.3 (95%CI 0.9-194.2)].

53.7% of mothers delivering prematurely had CMV lactatia; 23% of their infants were positive for CMV at 4-6 weeks of age.