INTRODUCTION Reports on the influence of postnatal cytomegalovirus (pCMV) infection in neonatal outcomes of preterm babies vary while guidance on management including screening is lacking. We aim to determine the association between symptomatic pCMV infection and chronic lung disease (CLD) and mortality in preterm infants born less than 32 weeks gestation. METHODS We used data from the Neonatal Intensive Care Units' (NICUS) population-based prospective data registry of infants in 10 neonatal units in New South Wales and the Australian Capital Territory, Australia. De-identified perinatal and neonatal outcome data for 40,933 infants were examined. We identified 172 infants <32 weeks gestation with symptomatic pCMV infection. Each was matched with one control infant. RESULTS Infants with symptomatic pCMV infection were 2.7 times more likely to develop CLD (OR 2.7, 95% CI: 1.7-4.5) and spend 25.2 days more in hospital (95% CI: 15.2-35.2). Seventy-five percent (129/172) of infants with symptomatic pCMV were extremely preterm (<28 weeks). The mean age of symptomatic pCMV diagnosis was 62.5 ± 20.5 days or 34.7 ± 3.6 weeks-corrected gestational age. Ganciclovir treatment did not decrease CLD and death. CLD was 5.5 times predictive of death in patients with symptomatic pCMV infection. Symptomatic pCMV infection did not influence mortality nor increase neurologic impairment. CONCLUSION Symptomatic pCMV is a modifiable factor affecting extreme preterm infants with significant impact on CLD. Prospective study on screening and treatment will help unveil potential benefits in our already at-risk preterm infants.

中文翻译：

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小于 32 周早产儿的症状性产后巨细胞病毒感染：13 年回顾性多中心病例对照研究。

引言 关于产后巨细胞病毒（pCMV）感染对早产儿新生儿结局的影响的报告各不相同，但缺乏包括筛查在内的管理指导。我们的目的是确定有症状的 pCMV 感染与妊娠 32 周以内出生的早产儿的慢性肺病 (CLD) 和死亡率之间的关联。方法 我们使用了新生儿重症监护病房 (NICUS) 基于人群的前瞻性数据登记册，该数据登记了澳大利亚新南威尔士州和澳大利亚首都地区 10 个新生儿病房的婴儿。对 40,933 名婴儿的去识别化围产期和新生儿结局数据进行了检查。我们确定了 172 名妊娠 <32 周的婴儿患有有症状的 pCMV 感染。每个婴儿都与一名对照婴儿相匹配。结果 有症状的 pCMV 感染的婴儿患 CLD 的可能性高出 2.7 倍（OR 2.7，95% CI：1.7-4.5），住院时间也长 25.2 天（95% CI：15.2-35.2）。75% (129/172) 患有 pCMV 症状的婴儿为极度早产（<28 周）。有症状的 pCMV 诊断的平均年龄为 62.5 ± 20.5 天或 34.7 ± 3.6 周校正胎龄。更昔洛韦治疗并没有减少慢性肺病和死亡率。对于有症状的 pCMV 感染患者，CLD 的死亡预测率为 5.5 倍。有症状的 pCMV 感染不会影响死亡率，也不会增加神经系统损伤。结论 症状性 pCMV 是影响极端早产儿的可改变因素，对 CLD 具有显着影响。关于筛查和治疗的前瞻性研究将有助于揭示对我们已经处于危险中的早产儿的潜在益处。