Table 1.
Infants fed | Study, by year of publication, country |
Methods: Inclusion Criteria |
Infants fed breast milk from CMV- seropositive mothers |
Infants with breast milk-acquired CMV infection |
Infants with CMV- related symptomsa |
Infants with CMV-SLSb |
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n | n (%) | Onset of CMV viruria | n (%) | n (%) | Onset of CMV viruria |
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Birth weight, grams |
Gestational age, weeks |
Chronological age, days Median (range) |
Corrected age for gestation, weeks Median (range) |
Corrected age for gestation, weeks Median (range) |
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Untreated breast milk | Hamprecht, 2001 Germany8 | <1500 | or | <32 | 90 | 33 (37) | 53.5 (27–120) | 34.5 (28.3–47.1) | 16 (18) | 4 (4) | 29.8 (28.3–32.1) |
Mussi-Pinhata, 2004 Brazil (Subgroup)25 | <1500 | or | <34 | 49 | 13 (27) | 75 (32–140)± | NA | 0 (0) | 0 (0) | - | |
Meier, 2005 Germany9 | ≤2,010* | <33 | 21 | 5 (24) | NA | NA | 2 (10) | 1 (5) | NA | ||
Miron, 2005 Israel26 | <1500 | or | <32 | 70 | 4 (6) | 35 (28–49) | 34 (31–35) | 3 (4) | 1 (1) | 31 | |
Croly-Labourdette, 2006 France10 | ≤2240* | <33 | 7 | 1(14) | 53 | 36.8 | 0 (0) | 0 (0) | - | ||
Capretti, 2009 Italy 11 | <1500 | and | <32 | 62 | 9 (15) | 51 (36–80) | 36.1 (31–41.4) | 8 (13) | 3 (5) | 33.4 (31–34) | |
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Overall (n) | 299 | 65 | 29 | 9 | |||||||
Pooled proportion from meta-analysis, % (95%CI) | 19 (11–32) | 10 (5–17) | 4 (2–7) | ||||||||
I2 | 77 | 50 | 0 | ||||||||
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Frozen breast milk | Yasuda, 2003 Japan12 | <1200 | or | <34 | 34 | 3 (9) | 54 (42–84) | 33.3 (33.1–39.7) | 0 (0) | 0 (0) | - |
Jim, 2004 Taiwan13 | <1500 | and | <35 | 40 | 6 (15) | 77§ (21–168) | NA | 6 (15) | 5 (13) | NA | |
Lee, 2007 USA27 | <1500 | or | <32 | 23 | 2 (9) | 40.5 (37–44) | 33.1 (29.3–33.1) | 1 (4) | 0 (0) | - | |
Jim, 2009 Taiwan14 | <1500 | and | <35 | 23 | 8 (35) | 63§ (SD=2.6) | NA | 3 (13) | 2 (9) | NA | |
Buxmann, 2009 Germany28 | <1710* | <31 | 35 | 5 (14) | 73 (43–89) | 35.7 (32.7–39.6) | 2 (6) | 0 (0) | - | ||
Chiavarini, 2011 Italy15 | <2000 | or | <32 | 57 | 1 (2) | 47 | 35.1 | 1 (2) | 1 (2) | 35.1 | |
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Overall (n) | 212 | 26 | 13 | 8 | |||||||
Pooled proportion from meta-analysis, % (95%CI) | 13 (7–24) | 7 (3–14) | 5 (2–12) | ||||||||
I2 | 62 | 37 | 33 | ||||||||
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Combinations of untreated, frozen, or pasteurized breast milk or non-specified | Mosca, 2001 Italy16 | ≤1380* | <34 | 30 | 5 (17) | 34 (NA) | NA | 0 (0) | 0 (0) | - | |
Sharland, 2002 UK29 | NA | <32 | 18 | 1(6) | 62 | 32.9 | 0 (0) | 0 (0) | - | ||
Mussi-Pinhata, 2004 Brazil (subgroup)25 | <1500 | or | <34 | 46 | 8 (17) | 75 (32–140)± | NA | 1 (2) | 0 (0) | - | |
Doctor, 2005 Canada30 | <1000 | <28* | 61 | 4 (7) | 48–72 | NA | 1 (2) | 1 (2) | NA | ||
Omarsdottir, 2007 Sweden17 | ≤1166* | <28* | 7 | 2 (29) | 34–46 | 31.3 (29.1–33.4) | 1 (14) | 1 (14) | 31.1 | ||
Hayashi, 2011 Japan31 | <1000 | or | <28 | 22 | 1 (5) | 70 | 36.7 | 1 (5) | 0 (0) | - | |
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Overall (n) | 184 | 21 | 4 | 2 | |||||||
Pooled proportion from meta-analysis, % (95%CI) | 13 (7–20) | 3 (1–8) | 3 (1–7) | ||||||||
I2 | 26 | 0 | 0 |
CMV-related symptoms defined as any of the following: neutropenia, thrombocytopenia, petechiae, hepatopathy, hyperbilirubinemia, elevated liver enzymes, jaundice or CMV pneumonia
CMV-SLS defined as sepsis-like symptoms, such as bradycardia, apnea or respiratory deterioration, in the absence of bacterial infection and coincident with CMV viruria.
The observed upper end of the birth weight and/or gestational age shown for studies that used only one criterion or none.
Median and range reported for all study infants, not just those shown in this category of breast milk
Mean; SD: Standard deviation
NA: Not available