Original ArticlePostnatal Human Cytomegalovirus Infection in Preterm Infants Has Long-Term Neuropsychological Sequelae
Section snippets
Methods
The present work is part of an ongoing project investigating the long-term cognitive, motor, and neurobiological outcome of preterm infants with early postnatal CMV infection via breast milk. The entire sample participated in observational studies on neonatal transmission rates,14, 15 and follow-up results of parts of our sample have been previously published, with respect to neurodevelopmental outcome between 2 and 4 years,10 between 4 and 8 years,13 and between 6 and 8 years.14 The current
Results
Demographic data are shown in Table I. Preterm and TERM groups were comparable in age and attention, but sex and maternal educational level differed significantly between groups. The 2 preterm groups did not differ in any of these covariates. Only 1 subject of the PRE CMV− group showed neurologic impairment in the form of bilateral spastic cerebral palsy, with only mild motor impairment in the upper extremity. Nine participants of the preterm group had MRI changes compatible with early white
Discussion
The present study indicates that an early postnatal CMV infection in preterm infants may have long-term neuropsychological sequelae, over and above those of preterm birth itself. In accordance with the literature,24, 25, 26, 27 our adolescents born preterm had compromised general intellectual and visuospatial abilities compared with TERM. Participants with early postnatal CMV infection scored significantly below those without such an infection in tests of general intelligence and—to a lesser
References (36)
- et al.
Congenital cytomegalovirus infection: new prospects for prevention and therapy
Pediatr Clin North Am
(2013) - et al.
Epidemiology of transmission of cytomegalovirus from mother to preterm infant by breastfeeding
Lancet
(2001) - et al.
Cytomegalovirus transmission to preterm infants during lactation
J Clin Virol
(2008) - et al.
Case-control study of symptoms and neonatal outcome of human milk-transmitted cytomegalovirus infection in premature infants
J Pediatr
(2006) - et al.
Transmission of cytomegalovirus via breast milk to the prematurely born infant: a systematic review
Clin Microbiol Infect
(2010) Gender aspects of preterm birth
BJOG
(2003)- et al.
Visual perceptual skills in children born with very low birth weights
J Pediatr Health Care
(2005) Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances
Lancet Neurol
(2009)- et al.
Brain maturation: predicting individual BrainAGE in children and adolescents using structural MRI
Neuroimage
(2012) - et al.
Neuroimaging of pediatric central nervous system cytomegalovirus infection
Radiographics
(2010)
Clinical, biochemical, and neuroimaging findings predict long-term neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection
J Pediatr
Cytomegalovirus transmission from breast milk in premature babies: does it matter?
Arch Dis Child Fetal Neonatal Ed
Postnatal cytomegalovirus: innocent bystander or hidden problem?
Arch Dis Child Fetal Neonatal Ed
Breastfeeding and the use of human milk
Pediatrics
Human Cytomegalovirus reactivation during lactation and mother-to-child transmission in preterm infants
J Clin Microbiol
Postnatally acquired cytomegalovirus infection via breast milk: effects on hearing and development in preterm infants
Pediatr Infect Dis J
Long-term outcome in preterm children with human cytomegalovirus infection transmitted via breast milk
Acta Paediatr
Long-term cognitive and neurological outcome of preterm infants with postnatally acquired CMV infection through breast milk
Arch Dis Child Fetal Neonatal Ed
Cited by (64)
Postnatal Cytomegalovirus Infection Among Preterm Infants
2023, Principles of NeonatologyViral Infections of the Fetus and Newborn
2023, Avery's Diseases of the NewbornThe epidemiology of cognitive development
2021, CognitionCitation Excerpt :Prenatal alcohol exposure also has negative consequences for cognitive development: meta-analytic studies suggest that moderate alcohol intake during pregnancy (3-6 drinks per week) is negatively associated with child behaviour outcomes (d = −0.15; Flak et al., 2014), while binge drinking (more than 4 drinks per occasion) and heavy drinking (more than 2 drinks per day) are negatively associated with general cognitive development (d = −0.13 for binge drinking, Flak et al., 2014; and d = −0.53 for heavy drinking, Testa, 2003). Various infections (e.g. toxoplasmosis, cytomegalovirus, zika, etc.) of the pregnant mother additionally have adverse effects on the foetus' cognitive development (Brecht et al., 2015; Sever et al., 1988; Valdes et al., 2019). Note that these are all raw associations, which may not necessarily reflect causal influences, as discussed in the next section on confounding factors.
Supported by the Deutsche Forschungsgemeinschaft (WI3630/1-1 and 1-2 [to M.W.]), and a Margarete von Wrangell Scholarship funded by the European Social Fund & Ministry of Science and the Arts, Baden-Württemberg (to K.L.). The authors declare no conflicts of interest.