Minimal adverse outcomes of postnatal cytomegalovirus infection in term or moderate and late preterm infants

Jie Chen; Yineng Zhou; Jie Tang; Chenyu Xu; Liping Chen; Biyun Xu; Yimin Dai; Yali Hu; Yi-Hua Zhou

doi:10.3389/fped.2023.1048282

Minimal adverse outcomes of postnatal cytomegalovirus infection in term or moderate and late preterm infants

Front Pediatr. 2023 Feb 3:11:1048282. doi: 10.3389/fped.2023.1048282. eCollection 2023.

Authors

Jie Chen¹, Yineng Zhou², Jie Tang^{3

4}, Chenyu Xu⁵, Liping Chen⁶, Biyun Xu⁷, Yimin Dai¹, Yali Hu¹, Yi-Hua Zhou⁸

Affiliations

¹ Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
² Department of Internal Medicine, Wuxi Children's Hospital, Wuxi, China.
³ Department of Obstetrics and Gynecology, Wujin Hospital Affiliated with Jiangsu University, Changzhou, China.
⁴ Department of Obstetrics and Gynecology, The Wujin Clinical College of Xuzhou Medical University, Changzhou, China.
⁵ Department of Obstetrics and Gynecology, Zhenjiang Fourth People's Hospital, Zhenjiang, China.
⁶ Department of Obstetrics and Gynecology, The First People's Hospital of Nantong, Nantong, China.
⁷ Medical Statistics and Analysis Center, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
⁸ Departments of Laboratory Medicine and Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.

Abstract

Objective: The aim of study was to investigate at what extent breastfeeding and vaginal delivery can increase mother-to-child transmission of cytomegalovirus (CMV) and to observe the clinical outcomes of postnatal infection in term or moderate and late preterm infants.

Methods: In this retrospective study of prospectively collected clinical data and serum samples, during 2012-2015, 380 women with CMV IgG positive/IgM negative and their 384 infants (4 twin pairs) with gestational age ≥32 weeks were included. CMV IgG and IgM were measured with enzyme-linked immunosorbent assay.

Results: Of 384 infants followed up at 10.2 ± 2.3 months age, 177 (46.1%) were defined with CMV infection based on the presence of higher CMV IgG levels than in their mothers. The infection rate in 190 breastfed infants was higher than in 194 formula-fed infants (62.6% vs. 29.9%, P < 0.001). Vaginally delivered infants (172) had higher CMV infection rate than 212 infants delivered by caesarean section (55.2% vs. 38.7%, P = 0.001). Compared with formula feeding and caesarean section, breastfeeding and vaginal delivery increased postnatal CMV infection respectively (OR = 3.801, 95% CI 2.474-5.840, P < 0.001; OR = 1.818, 95% CI 1.182-2.796, P = 0.007). Nevertheless, compared to uninfected infants, CMV-infected infants had comparable height and body weight and showed no adverse effect on the liver enzymes.

Conclusion: Breastfeeding and vaginal delivery can increase postnatal CMV infection; however, the infection does not influence the growth of the term infants or preterm infants with gestational age ≥32 weeks. Thus, breastfeeding should be encouraged in these infants regardless of maternal CMV IgG status.

Keywords: breast milk; clinical outcomes; cytomegalovirus; delivery; term or moderate or late preterm infants.

Grants and funding

This study was supported by the National Natural Science Foundation of China (81672002), the Science and Technology Department of Jiangsu Province (BK20221169), the Health Commission of Nanjing City (ZKX20021), and the Science and Technology Department of Changzhou City (CJ20220009), Jiangsu Province, China.