Prevention of Cytomegalovirus Transmission via Breast Milk in Extremely Low Birth Weight Infants
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Purpose: Extremely low birth weight infants (ELBWIs) have a high risk of acquiringcytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs. Materialsand Methods: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequentpositive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcomeat corrected age [(CA): 2 years of CMV infection] were analyzed. Results: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and ≥moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestationalage and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (≥moderate) was the only significant adverse outcome associatedwith this CMV infection. Conclusion: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.
Abstract
Purpose: Extremely low birth weight infants (ELBWIs) have a high risk of acquiringcytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs. Materialsand Methods: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequentpositive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcomeat corrected age [(CA): 2 years of CMV infection] were analyzed. Results: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and ≥moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestationalage and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (≥moderate) was the only significant adverse outcome associatedwith this CMV infection. Conclusion: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.
참고문헌 (46)
- Lawrence RA, "The evidence for growth standards and iron in moderation and exclusive breastfeeding", Breastfeed Med, 1, pp.205~206 (2006)
- Hamprecht K, "Cytomegalovirus transmission to preterm infants during lactation", J Clin Virol, 41, pp.198~205 (2008)
- Vohr BR, "Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age", Pediatrics, 120, pp.e953~e959 (2007)
- Dougherty D, "Birth to breast--a feeding care map for the NICU: helping the extremely low birth weight infant navigate the course", Neonatal Netw, 27, pp.371~377 (2008)
- Nijman J, "Postnatally acquired cytomegalovirus infection in preterm infants: a prospective study on risk factors and cranial ultrasound findings", Arch Dis Child Fetal Neonatal Ed, 97, pp.F259~F263 (2012)
- Numazaki K, "Human cytomegalovirus infection of breast milk", FEMS Immunol Med Microbiol, 18, pp.91~98 (1997)
- Vochem M, "Transmission of cytomegalovirus to preterm infants through breast milk", Pediatr Infect Dis J, 17, pp.53~58 (1998)
- Hamprecht K, "Epidemiology of transmission of cytomegalovirus from mother to preterm infant by breastfeeding", Lancet, 357, pp.513~518 (2001)
- Bae CW, "Maternal diseases and breastfeeding", Hanyang Med Rev, 30, pp.60~67 (2010)
- Dworsky M, "Persistence of cytomegalovirus in human milk after storage", J Pediatr, 101, pp.440~443 (1982)
- Friis H, "Rate of inactivation of cytomegalovirus in raw banked milk during storage at -20 degrees C and pasteurisation", Br Med J (Clin Res Ed), 285, pp.1604~1605 (1982)
- Hamprecht K, "Cytomegalovirus (CMV) inactivation in breast milk: reassessment of pasteurization and freeze-thawing", Pediatr Res, 56, pp.529~535 (2004)
- Ewaschuk JB, "Effect of pasteurization on selected immune components of donated human breast milk", J Perinatol, 31, pp.593~598 (2011)
- Maschmann J, "Freeze-thawing of breast milk does not prevent cytomegalovirus transmission to a preterm infant", Arch Dis Child Fetal Neonatal Ed, 91, pp.F288~F290 (2006)
- Schanler RJ, "Suitability of human milk for the low-birthweight infant", Clin Perinatol, 22, pp.207~222 (1995)
- Perinatal cytomegalovirus infection associated with freeze-thawed breast milk feeding in extremely low birth weight infants (<1000 gm), "Yoo HS", In SPR (Society for Pediatric Research), ~ (2009)
- Klein JO, "Infectious Diseases of the Fetus and Newborn Infant" (2011), Elsevier
- Ehrenkranz RA, "Validation of the National Institutes of Health consensus definition of bronchopulmonary dysplasia", Pediatrics, 116, pp.1353~1360 (2005)
- Papile LA, "Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm", J Pediatr, 92, pp.529~534 (1978)
- Bell MJ, "Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging", Ann Surg, 187, pp.1~7 (1978)
- "An international classification of retinopathy of prematurity", Arch Ophthalmol, 102, pp.1130~1134 (1984), The Committee for the Classification of Retinopathy of Prematurity
- Leonard CH, "Use of the Bayley Infant Neurodevelopmental Screener with low birth weight infants", J Pediatr Psychol, 26, pp.33~40 (2001)
- Shankaran S, "Outcome of extremely-low-birth-weight infants at highest risk: gestational age < or =24 weeks, birth weight < or =750 g, and 1-minute Apgar < or =3", Am J Obstet Gynecol, 191, pp.1084~1091 (2004)
- Ancel PY, "Cerebral palsy among very preterm children in relation to gestational age and neonatal ultrasound abnormalities: the EPIPAGE cohort study", Pediatrics, 117, pp.828~835 (2006)
- Maschmann J, "Cytomegalovirus infection of extremely low-birth weight infants via breast milk", Clin Infect Dis, 33, pp.1998~2003 (2001)
- Nijman J, "Urine viral load and correlation with disease severity in infants with congenital or postnatal cytomegalovirus infection", J Clin Virol, 54, pp.121~124 (2012)
- Hayashi S, "Transmission of cytomegalovirus via breast milk in extremely premature infants", J Perinatol, 31, pp.440~445 (2011)
- Okulu E, "Severe postnatal cytomegalovirus infection with multisystem involvement in an extremely low birth weight infant", J Perinatol, 32, pp.72~74 (2012)
- Hamprecht K, "Rapid detection and quantification of cell free cytomegalovirus by a high-speed centrifugation-based microculture assay: comparison to longitudinally analyzed viral DNA load and pp67 late transcript during lactation", J Clin Virol, 28, pp.303~316 (2003)
- Jim WT, "High cytomegalovirus load and prolonged virus excretion in breast milk increase risk for viral acquisition by very low birth weight infants", Pediatr Infect Dis J, 28, pp.891~894 (2009)
- Mussi-Pinhata MM, "Placental transfer of naturally acquired, maternal cytomegalovirus antibodies in term and preterm neonates", J Med Virol, 69, pp.232~239 (2003)
- Palmeira P, "IgG placental transfer in healthy and pathological pregnancies", Clin Dev Immunol, 2012, pp.985646~ (2012)
- Doctor S, "Cytomegalovirus transmission to extremely low-birthweight infants through breast milk", Acta Paediatr, 94, pp.53~58 (2005)
- Capretti MG, "Very low birth weight infants born to cytomegalovirus-seropositive mothers fed with their mother’s milk: a prospective study", J Pediatr, 154, pp.842~848 (2009)
- Cheong JL, "Gastrointestinal manifestations of postnatal cytomegalovirus infection in infants admitted to a neonatal intensive care unit over a five year period", Arch Dis Child Fetal Neonatal Ed, 89, pp.F367~F369 (2004)
- Arellano-Galindo J, "Detection and gB genotyping of CMV in Mexican preterm infants in the context of maternal seropositivity", J Infect Dev Ctries, 8, pp.758~767 (2014)
- Mehler K, "High rate of symptomatic cytomegalovirus infection in extremely low gestational age preterm infants of 22-24 weeks’ gestation after transmission via breast milk", Neonatology, 105, pp.27~32 (2014)
- Yeager AS, "Prevention of transfusion-acquired cytomegalovirus infections in newborn infants", J Pediatr, 98, pp.281~287 (1981)
- Snydman DR, "Use of cytomegalovirus immunoglobulin in multiply transfused premature neonates", Pediatr Infect Dis J, 14, pp.34~40 (1995)
- Kurath S, "Transmission of cytomegalovirus via breast milk to the prematurely born infant: a systematic review", Clin Microbiol Infect, 16, pp.1172~1178 (2010)
- Jim WT, "Transmission of cytomegalovirus from mothers to preterm infants by breast milk", Pediatr Infect Dis J, 23, pp.848~851 (2004)
- Mussi-Pinhata MM, "Perinatal or early-postnatal cytomegalovirus infection in preterm infants under 34 weeks gestation born to CMV-seropositive mothers within a high-seroprevalence population", J Pediatr, 145, pp.685~688 (2004)
- Yasuda A, "Evaluation of cytomegalovirus infections transmitted via breast milk in preterm infants with a real-time polymerase chain reaction assay", Pediatrics, 111(6 Pt 1), pp.1333~1336 (2003)
- Meier J, "Human cytomegalovirus reactivation during lactation and mother-to-child transmission in preterm infants", J Clin Microbiol, 43, pp.1318~1324 (2005)
- Ford JE, "Influence of the heat treatment of human milk on some of its protective constituents", J Pediatr, 90, pp.29~35 (1977)
- Goldblum RM, "Goldman AS. Rapid high-temperature treatment of human milk", J Pediatr, 104, pp.380~385 (1984)