Transmissão perinatal do citomegalovírus em recém-nascidos pré-termo através do leite materno

Abstract

Human cytomegalovirus (CMV) is a double-stranded linear DNA virus and has a wide distribution worldwide. Breastfeeding represents an important route of perinatal transmission of CMV from mother to child. The aim of this study was to evaluate the perinatal transmission of CMV in premature newborns (NB) from a NICU through breastfeeding. The study was observational, longitudinal cohort, prospective, involving premature newborns admitted to the NICU of the Januário Cicco Maternity School (MEJC) between September 2021 and June 2022 with gestational age less than 33 weeks or birth weight less than 1500g. All mothers underwent postpartum blood draws and were tested for CMV seropositivity. The biological samples of preterm infants' urine and breast milk were submitted to molecular biology techniques (extraction, PCR, and electrophoresis). Clinical and laboratory data were obtained from medical records. The results showed seropositivity for IgG anti-CMV antibodies in 76/77 mothers (98.70%) and IgM in 3/77 patients (3.90%). The rate of virus detection in breast milk was analyzed in 21/63 (33%) mothers with available milk samples. The CMV-excreting mothers group had a lower median maternal age compared to the non-excreting mothers group with statistically significant differences. Birth weight was lower for the group of preterm infants born to mothers excreting CMV in milk (1,171 ± 390) compared to the group of preterm infants born to mothers not excreting CMV in milk (1,450 ± 450) with statistically significant differences. The incidence of perinatal infection via breast milk was analyzed in 3/45 (6.66%) RNs with available urine samples. It was not possible to associate perinatal infection with clinical symptoms and risk factors for disease development due to the limited incidence of perinatal infection cases. Therefore, developing new multicenter, prospective studies with premature infants are crucial to definitively establish the true risk/benefit balance of CMV exposure through breastfeeding with fresh breast milk in NICU settings.