Kurath et al.: Transmission of cytomegalovirus via breast milk to the premature born infant: a systematic review
Kurath, S; Halwachs-Baumann, G; Müller, W; Resch, B.
Transmission of cytomegalovirus via breast milk to the premature born infant: a systematic review.
Clin Microbiol Infect. 2009; [Fulltext] [PubMed]
- Abstract To analyze current data on transmission of cytomegalovirus (HCMV) via breast milk with subsequent symptomatic HCMV infection of the preterm infant and to report on long-term follow-up. A systematic literature review on transmission of HCMV via breast milk to the premature born infant was performed using Medline, Embase and Cinahl (1966 - Dec 2008) Studies were included for analysis if congenital HCMV infection was excluded and transmission via breast milk was either confirmed or highly suspicious. Twenty-six studies were included for analysis. Maternal HCMV-IgG positivity was reported to range from 51.6 to 100 percent (median 81.6%), HCMV-IgG detection in breast milk from 67 to 97.2 percent (median 80%), and HCMV-positivity of the infants from 5.7 to 58.6 percent. Symptomatic HCMV disease occurred in 0 to 34.5 percent (median 3.7%) and severe sepsis-like syndrome in 0 to 13.8 percent (median 0.7%). Data on long term outcome of preterm infants with symptomatic HCMV infection revealed a low risk for mild neurologic and cognitive sequelae without hearing impairment. Recommendations for high risk preterm infants diverged markedly.Current data report on low rates of symptomatic disease following transmission of cytomegalovirus (HCMV) via breast milk to the preterm infant without evidence of certain long-term sequelae. Results do not support a general approach by either avoidance or pasteurization of breast milk in high risk preterm infants.