Am J Perinatol 2016; 33(09): 894-902
DOI: 10.1055/s-0036-1581080
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Symptomatic Postnatal Cytomegalovirus Testing among Very Low-Birth-Weight Infants: Indications and Outcomes

Sagori Mukhopadhyay
1  Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
2  Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Sarah A. Meyer
3  Department of Pediatric Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
Sallie R. Permar
4  Department of Pediatrics, Duke University Medical Center, Durham, North Carolina
5  Human Vaccine Institute, Duke University Medical Center, Durham, North Carolina
,
Karen M. Puopolo
1  Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
2  Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
› Author Affiliations
Further Information

Publication History

24 October 2015

12 February 2016

Publication Date:
08 April 2016 (online)

Abstract

Objective The objective of this study was to describe the indications for postnatal cytomegalovirus (CMV) testing among very low-birth-weight (VLBW, birth weight [BW] < 1,500 g) infants, clinical characteristics of infected infants, and adverse outcomes associated with CMV infection.

Study Design This is a single-center, retrospective study of 2,132 VLBW infants from 1999 to 2013.

Results In this study, 145 (6.8%) infants out of 2,132 were evaluated for postnatal CMV infection and 27 (18.6%) infants out of 145 were infected. CMV-tested infants were of significantly lower gestational age and BW compared with untested VLBW infants (p < 0.001). Respiratory decompensation and thrombocytopenia were the findings most commonly associated with infection. CMV-infected infants had significantly more exposure to mechanical ventilation and longer duration of hospitalization. Adjusting for multiple predictors of respiratory morbidity, the incidence of bronchopulmonary dysplasia (BPD) was significantly elevated among infants diagnosed with postnatal CMV infection (odds ratio, 4.0 [95% confidence interval, 1.3–12.4); p, 0.02.)

Conclusion Symptomatic postnatal CMV infection was diagnosed in 1.3% of VLBW infants, most commonly among infants with BW < 1,000 g with respiratory instability and thrombocytopenia. Similar to late-onset bacterial infection, symptomatic postnatal CMV infection may be an independent contributor to the development of BPD. This possibility should be addressed in a prospective study of extremely low BW infants.