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Transmission of cytomegalovirus in fresh and freeze–thawed mother’s own milk to very preterm infants: a cohort study

Journal of Perinatology volume 41, pages 1873–1878 (2021)Cite this article

Subjects

Abstract

Objectives

The objectives of the study were to clarify: (i) the frequency of human cytomegalovirus (HCMV) transmission, (ii) the association between the viral load in mother’s own milk (MOM), the amount of fresh MOM and transmission, and (iii) the frequency of sepsis-like-symptoms (SLS) among infants born to seropositive mothers compared to infants born to seronegative mothers.

Study design

This prospective cohort study enrolled very preterm infants (gestational age <32 weeks) from Denmark. Weekly samples of fresh MOM and urine were analyzed for HCMV-DNA.

Results

Twenty-six very preterm infants were enrolled. Four acquired an HCMV infection, of which two developed SLS. HCMV-infected infants received MOM with a significant higher viral load compared to the HCMV-uninfected infants.

Conclusion

A combination of a high viral load and an increased amount of fresh MOM increased the risk of HCMV transmission. SLS was only slightly more common among infants exposed to HCMV positive MOM.

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Fig. 1: Flowchart of the study.
Fig. 2: Kinetics of human cytomegalovirus in fresh mother’s own milk (MOM).
Fig. 3: HCMV in MOM and amount of fresh MOM.

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Acknowledgements

The authors thank the parents and infants for participating in the study. We also thank the nurses at the neonatal intensive care unit, Odense University Hospital, and the biomedical laboratory scientists and Rune Micha Pedersen and Marianne Skov at the Department of Clinical Microbiology, Odense University Hospital.

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Author notes

  1. These authors contributed equally: Christina Volder, Benedicte Juul Work.

Authors and Affiliations

  1. Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Christina Volder, Benedicte Juul Work & Gitte Zachariassen

  2. OPEN—Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Odense, Denmark

    Christina Volder, Benedicte Juul Work & Gitte Zachariassen

  3. Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark

    Silje Vermedal Hoegh

  4. H.C. Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark

    Maria-Christina Eckhardt & Gitte Zachariassen

Authors
  1. Christina Volder
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  2. Benedicte Juul Work
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  4. Maria-Christina Eckhardt
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  5. Gitte Zachariassen
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Contributions

CV and BJW designed the study, collected data, carried out the analyses, drafted the paper, and revised the paper. They contributed equally as co-first authors. MCE collected data and reviewed the paper. SVH was responsible for the analyses methods and reviewed the paper. GZ conceptualized and designed the study, coordinated and supervised data collection, and critically reviewed the paper for important intellectual content. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Gitte Zachariassen.

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Competing interests

The authors declare no competing interests.

Ethical approval

Written consents from the parents were obtained, after oral, and written information. The study was conducted in accordance with the declaration of Helsinki and approved by the local ethical committee in the region of Southern Denmark (S-20180187) and the data protection agency at Odense University Hospital (April 3rd, 2019).

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Volder, C., Work, B.J., Hoegh, S.V. et al. Transmission of cytomegalovirus in fresh and freeze–thawed mother’s own milk to very preterm infants: a cohort study. J Perinatol 41, 1873–1878 (2021). https://doi.org/10.1038/s41372-021-01129-z

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