Cytomegalovirus infections in neonates acquired by blood transfusions

Abstract

One hundred seventy-eight newborns were cultured for cytomegalovirus (CMV) on admission and weekly after 4 weeks of age until discharge. Eight (all with birth weights of 1050 g or less) acquired CMV while hospitalized. At least seven of the infected infants were born to CMV-seronegative mothers. The risk for seronegative infants weighing less than 1250 g of acquiring CMV was 24%. There was no correlation between duration of hospitalization and birth weight for infants hospitalized over 30 days. There was a significant correlation (P < 0.0001) between the number of blood donors for an infant and the acquisition of CMV. Infected infants received blood from eight or more donors prior to CMV shedding. Infected low birth weight infants received blood from an average of 6.5 CMV antibody-positive donors, while uninfected low birth weight infants received blood from an average of 3.1 CMV antibody-positive donors. No infant received nonmaternal breast milk. After acquiring CMV, three infants died (only one was autopsied and had proved disseminated CMV disease), two developed hepatitis and one developed hepatosplenomegaly. These results suggest that acquired CMV infection is a significant risk to seronegative low birth weight infants who receive blood from seropositive blood donors.