The prevalence of IgG antibody against cytomegalovirus (CMV) was compared between the age-matched (0 month to 2 years of age) groups of 212 breast-fed children and 223 bottle-fed children to examine the role of breast milk for acquisition of CMV. Mothers of both groups of children were also examined for CMV IgG antibodies. Both the breast-fed and bottle-fed children groups showed high seropositivity for CMV at 0 to 2 months of age, which gradually decreased and bottomed at 6 to 8 months of age. Thereafter, in the breast-fed children group, the seropositivity rate increased up to 70% by 1 year of age. In contrast, in the bottle-fed children group, the seropositivity rate remained at the bottom level of lower than 30%, without showing any apparent increases. The serological data of the children whose mothers were confirmed to be seropositive, revealed that mother-to-child transmission of CMV occurred in 11 of 17 (64.7%) of the breast-fed children and in 24 of 87 (27.6%) of the bottle-fed children. All the bottle-fed children born to seronegative mothers remained seronegative for CMV up to 1 year of age. The bottle-fed children showed significantly lower seropositivity than the breast-fed children, although most of both groups of children were born to seropositive mothers. The results strongly suggested that about 40% of the breast-fed children acquire CMV via breast milk and breast-feeding has certain protective effects on congenital CMV disease in the offspring. CMV is known to be one of the most common viruses which are transmitted transplacentally. In fact, congenital CMV infection occurs at incidences ranging from 0.2 to 2.2% among all live births, as reviewed by Stagno and Whitley (15). Although most of these congenitally infected newborns show no clinical signs of CMV infection, approximately 10% of them will develop congenital cytomegalic inclusion disease with sequelae (1, 11).Moreover, CMV infection which occurs during or after delivery is much more common than congenital infection. Such perinatal CMV infection is usually acquired through contact with breast milk and/or cervical secretions. In fact, Numazaki et al reported that approximately 30% of the pregnant women excreted CMV in the cervical excretions and more than 60% of newborn infants in Japan were vertically infected by CMV via the birth canal (8). On the other hand, CMV was isolated from breast milk, and CMV infection via breast milk was also reported (2, 5, 9, 13). Breast milk has then also been considered as an important route of mother-to-child transmission of CMV (9). In the present study, we compared the prevalence of CMV antibodies between the age-matched groups of breast-fed children and bottle-fed children. The serological status of mothers of both the breast-fed and bottle-fed children was also examined. An evidence that the seropositivity is apparent higher in the breast-fed children than in the bottle-fed children suggests an important role of breast milk
HTLV‐I transmission routes were found for 66 carrier pregnant women by studying sera, from the carrier pregnant women, their mothers, and their husbands, and by obtaining detailed family histories at interview. Forty‐one cases (62.1%) were considered to be instances of vertical transmission, 15 (22.8%) of sexual transmission, 6 (9.1%) of blood transfusion, and 4 (6.1%) undecided. To date, most cases of adult T‐cell leukemia (ATL) have been considered to result from vertical transmission. Our results therefore imply that about 30% (22.8%+ 9.1%) of the carrier pregnant women are at minimal risk of ATL. Moreover, in case of presumed husband‐to‐wife transmission, more than half (6/11) were infected between one year and four years after marriage.
This study was conducted in order to investigate the usefulness of granulocyte elastase levels as predicitve factors in the onset of perinatal infections. The subjects were 41 patients who delivered within 48 h after amniocentesis after giving their informed consent. The relationship between cervical granulocyte elastase (Cx-E), serum C-reactive protein (CRP) and amniotic fluid granulocyte elastase (Af-E), and placental infections and neonatal infections was comparatively investigated. In some cases, gastric juice granulocyte elastase in neonates (Gj-E) was measured, and the correlation by site was investigated. Elastase levels were not used as a management protocol. In predicting neonatal infections, diagnostic efficacy (sensitivity × specificity) of placental infections (0.97) and abnormal Af-E (0.79) were superior to those of abnormal Cx-E (0.40) and abnormal CRP (0.49). There was no correlation between Cx-E and Af-E or between Cx-E and Gj-E; however, a very close correlation was noted between Af-E and Gj-E. In predicting abnormal amniotic fluids, Cx-E (≥1.2 µg/ml) + CRP (≥1.0 mg/dl) had the highest diagnostic efficacy with 0.58. These findings demonstrate that Af-E is a good index for predicting the onset of neonatal infections. In predicting abnormal amniotic fluid, it might be advisable to consider amniocentesis in order to diagnose intrauterine infections, when both Cx-E and CRP show abnormal levels.
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