Ay. Yamamoto et al., Congenital cytomegalovirus infection in preterm and full-term newborn infants from a population with a high seroprevalence rate, PEDIAT INF, 20(2), 2001, pp. 188-192
Background. Cytomegalovirus (CMV) is the most frequent cause of congenital
infections in humans. Prematurity occurs in as many as 34% of infants with
symptomatic congenital CMV infection.
Objective. To determine the clinical presentation and frequency of congenit
al CMV infection among preterm infants and full-term infants from a populat
ion with a high seroprevalence rate.
Design/methods. A total of 289 preterm infants (median gestational age, 34
weeks; median birth weight, 1757 g) and 163 term infants (median gestationa
l age, 39 weeks; median birth weight, 3150 g) sequentially born were includ
ed in the study. Serum IgG antibodies to CMV were measured in all mothers.
One urine sample was collected within the first 7 days of age from all newb
orns. Virus isolation in urine samples was performed by tissue culture, and
viral DNA was detected by a multiplex PCR. CMV infection was diagnosed in
infants with virus excretion detected by both methods on at least two occas
ions within the first 3 weeks of life.
Results. Maternal CMV seropositivity rate was 95.7%. Congenital CMV infecti
on was detected in 6 of 289 (2.1%) (95% confidence interval, 0.84 to 4.68)
preterm infants and in 3 of 163 term infants (1.8%) (95% confidence interva
l, 0.48 to 5.74) (P > 0.05). Four of 6 preterm infants with congenital CMV
infection were symptomatic, but none of the term infants was symptomatic (P
= 0.16).
Conclusion. The frequency of congenital CMV infection in preterm newborn in
fants from mothers with a high seropositive rate was similar to that found
in term infants. No significant difference was found between the proportion
of symptomatic infants among preterm and term infants. Our finding of symp
tomatic congenital CMV infection underscores the need of further evaluation
of correlates of congenital symptomatic infection in highly immune populat
ions.