Association of Cytomegalovirus Infection in Preterm Infants and Neonatal Outcomes: A Matched Cohort Study

Abstract

Objectives

This study aimed to explore the association of cytomegalovirus (CMV) infection in preterm infants of ≤32 weeks' gestation and neonatal morbidities.

Study Design

This was a matched cohort study of preterm infants born between 22 and 32 weeks gestation age and <1,500 g in birth weight who were admitted to participating tertiary NICUs within the Canadian Neonatal Network between April 2009 and December 2018. Infants were randomly matched in a 1:4 ratio (73 CMV-positive to 292 CMV-nonpositive infants) based on gestational age (in weeks), sex, birth weight (± 50 g), and number of days of oxygen exposure within the first 28 days after birth (± 2 days). Neonatal morbidities were compared between the two groups using conditional logistic regression after adjustment of unmatched confounders.

Results

The CMV-positive infants were of lower median birth weight compared to CMV-nonpositive infants (722 vs. 743 g; p < 0.05). The duration of noninvasive respiratory support (59 vs. 43 days; p < 0.05), invasive respiratory support (35 vs. 24 days; p < 0.05), oxygen therapy (115 vs. 67 days; p < 0.05), and odds of bronchopulmonary dysplasia (BPD; 90% vs. 71%; adjusted odds ratio: 3.52 [1.54, 8.07]) were higher for CMV-positive infants compared to CMV-nonpositive infants. Other morbidities were not statistically significantly different.

Conclusion

CMV infection in very preterm infants was associated with increased duration of oxygen and respiratory support and increased odds of BPD.

Key Points

• Congenital CMV is the most common congenital infection.

• There is limited knowledge of the effect of congenital and postnatal CMV on neonatal morbidities.

• We identified that CMV positivity in preterm infants is associated with higher odds of BPD.

Keywords

preterm - bronchopulmonary dysplasia - chronic lung disease

• References

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