Table 3.
CMV-positive vs. CMV-negative cholestatic infants.
| CMV PCR in any sample (sedimented whole blood, plasma or urine) | p b | ||
|---|---|---|---|
| Positive (n = 31)a | Negative (n = 14)a | ||
| Mother and pregnancy | |||
| Maternal age | 31 (27, 35) | 32.5 (27, 35) | 0.74 |
| Preeclampsia | 6/31 (19) | 0/14 (0) | 0.16 |
| Chorioamnionitis | 6/31 (19) | 3/14 (21) | 1.00 |
| Steroids, antenatal | 27/31 (87) | 12/14 (86) | 1.00 |
| Cesarean delivery | 23/31 (74) | 10/14 (71) | 1.00 |
| Neonatal characteristics | |||
| Gestational age, week+day | 27+0 (26+0, 29+2) | 26+1 (25+1, 26+6) | 0.19 |
| Birth weight, g | 997 (735, 1,235), n = 30 | 903 (748, 1,070) | 0.61 |
| Female gender | 14/31 (45) | 7/14 (50) | 1.00 |
| Small for gestational age | 10/30 (33) | 5/14 (36) | 1.00 |
| Cholestasis | |||
| Age at cholestasis onset, days | 18 (7.5, 23) | 20 (8, 30) | 0.55 |
| Duration cholestasis, CB <30 μmol/L | 67 (28, 84), n = 23 | 77 (71, 99) | 0.13 |
| TB peak before cholestasis onset, μmol/L | 164 (140, 208), n = 29 | 170 (120, 200) | 0.80 |
| TB peak during cholestasis, μmol/L | 168 (144, 271) | 150 (106, 241) | 0.35 |
| CB peak, μmol/L | 117 (70, 195) | 113 (75, 164) | 0.85 |
| Age at peak CB, days | 40 (24, 61) | 49 (32, 65) | 0.57 |
| ALT peak, μkat/Lc | 1.05 (0.76, 1.97) | 1.94 (1.38, 2.54), n = 13 | 0.21 |
| AST peak, μkat/Lc | 2.30 (1.49, 3.29) | 3.96 (1.98, 4,78) | 0.27 |
| γ-GT peak, μkat/Lc | 3.05 (2.00, 4.95), n = 28 | 2.60 (1.70, 3.80), n = 13 | 0.31 |
| INR peak | 2.3 (1.8, 2.7) | 2.3 (1.9, 2.9) | 0.66 |
| Lowest thrombocyte count, 109/L | 34 (13, 84.5) | 52.5 (23, 74) | 0.48 |
| Vitamin K treatment | 25/30 (83) | 14/14 (100) | 0.16 |
| Ursodeoxycholic acid treatment | 26/29 (90) | 14/14 (100) | 0.54 |
| Maternal CMV serostatus | |||
| IgG +, IgM – | 15/22 (68) | 8/12 (67) | 1.00 |
| IgG +, IgM + | 1/22 (5) | 1/12 (8) | 1.00 |
| IgG −, IgM + | 0/22 (0) | 1/12 (8) | 0.35 |
| IgG –, IgM – | 6/22 (27) | 2/12 (17) | 0.68 |
| Neonatal course | |||
| Mechanical ventilation, days | 24 (12, 40) | 23 (16, 33) | 0.94 |
| Lowest thrombocyte count, × 109/L | 34 (13, 85) | 53 (23, 74) | 0.48 |
| Sepsis | 21/31 (67) | 7/14 (50) | 0.33 |
| Blood transfusions | 14 (9, 21) | 17 (13, 21) | 0.42 |
| Necrotizing enterocolitis | 17/31 (55) | 3/14 (21) | 0.054 |
| Stoma | 9/31 (29) | 2/14 (14) | 0.46 |
| Patent ductus arteriosus | 19/31 (61) | 10/14 (71) | 0.38 |
| IVH, ≥grade 3 | 4/31 (13) | 1/14 (7) | 1.00 |
| Nutrition and growth | |||
| Any maternal breast milk | 26/31 (84) | 13/14 (93) | 0.65 |
| Maternal breast milk before cholestasis | 20/29 (69) | 8/14 (57) | 0.51 |
| Any donor breast milk | 22/30 (73) | 10/14 (71) | 1.00 |
| Donor breast milk before cholestasis | 19/29 (66) | 10/14 (71) | 1.00 |
| Parenteral nutrition, ≥2 weeks | 29/31 (94) | 13/14 (93) | 0.48 |
| Clinoleic (Baxter) at any time | 14/31 (45) | 8/14 (57) | 0.53 |
| Intralipid (Fresenius Kabi) at any time | 20/31 (65) | 8/14 (57) | 0.74 |
| Omegaven (Fresenius Kabi) at any time | 13/31 (42) | 6/14 (43) | 1.00 |
| Outcomes | |||
| ROP, ≥grade 3 | 8/28 (29) | 4/14 (29) | 1.00 |
| BPD, grade 2 or higher | 15/26 (58) | 9/14 (64) | 0.75 |
| Mortality | 8/31 (26) | 0/14 (0) | 0.044* |
| Hearing disability in childhood | 3/13 (23) | 1/10 (10) | 0.60 |
CMV, cytomegalovirus; PCR, polymerase chain reaction; CB, conjugated bilirubin; TB, total bilirubin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; γ-GT, gamma glutamyl transpeptidase; INR, international normalized ratio; IgG, immunoglobulin G; IgM, immunoglobulin M; IVH, intraventricular hemorrhage; ROP, retinopathy of prematurity; BPD, bronchopulmonary dysplasia.
a
n/N (%) for proportions, median ([IQR:] 25th percentile, 75th percentile) for continuous variables.
b
Fisher exact test for proportions, Mann–Whitney U-test for continuous variables.
c
1 μkat/L ≈ 60 U/L. Upper reference: ALT < 0.85 μkat/L, AST < 1.4 μkat/L, γ-GT < 0.27 μkat/L.
*
Statistical significance.