{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:00:13Z","timestamp":1790398813869,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n Postnatally acquired cytomegalovirus (pCMV) infection may cause severe disease in extremely preterm infants, but its clinical significance remains uncertain. We investigated the incidence, timing, disease burden, and diagnostic performance of saliva screening.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n In this prospective cohort study, infants born at <\u200928\u2009weeks of gestation or with a birth weight\u2009<\u20091200\u2009g to CMV\u2010seropositive mothers and fed untreated mothers' own milk underwent weekly saliva and urine CMV polymerase chain reaction testing. Outcomes before discharge and at 2\u2009years corrected age were compared between CMV\u2010positive and CMV\u2010negative infants.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Forty\u2010five infants were included, of whom 20 (44%) acquired pCMV. CMV was detected at a median age of 44\u2009days in saliva, 50\u2009days in urine, and 55\u2009days in blood. Two (10%) infected infants developed severe disease requiring antiviral treatment. No significant differences were observed in neonatal morbidity, hospitalisation duration, mortality, or neurodevelopmental outcomes. Saliva PCR demonstrated a sensitivity of 86% and a specificity of 93%.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n pCMV transmission was common in extremely preterm infants receiving mothers' own milk, but clinically significant disease occurred in only a minority of infected infants. Saliva\u2010based screening demonstrated acceptable diagnostic performance and may facilitate early recognition and targeted management of clinically significant pCMV infection.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apa.70779","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:32:13Z","timestamp":1790397133000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postnatally Acquired Cytomegalovirus Infection in Extremely Premature Infants: A Prospective Observational Cohort Study"],"prefix":"10.1111","author":[{"given":"Sara Kr\u00f8is","family":"Holm","sequence":"first","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Neonatology Copenhagen University Hospital, Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0965-429X","authenticated-orcid":false,"given":"Lise","family":"Aunsholt","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0331-1384","authenticated-orcid":false,"given":"Porntiva","family":"Poorisirak","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3426-0014","authenticated-orcid":false,"given":"Alex Christian Yde","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Microbiology Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rune Micha","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Odense University Hospital Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark, Odense Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3087-3983","authenticated-orcid":false,"given":"Bo M\u00f8lholm","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Copenhagen University Hospital North Zealand, Hilleroed Hilleroed Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Mette","family":"Plomgaard","sequence":"additional","affiliation":[{"name":"Department of Neonatology Copenhagen University Hospital, Hvidovre Hvidovre Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina Kwi Im","family":"Jordan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Copenhagen University Hospital Herlev, Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-1140","authenticated-orcid":false,"given":"Hristo","family":"Stanchev","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine Slagelse Hospital Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9490-9586","authenticated-orcid":false,"given":"Maren","family":"Rytter","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Pediatrics and Adolescent Medicine Slagelse Hospital Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-2403","authenticated-orcid":false,"given":"Tatjana","family":"Zaharov","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nykobing Falster Hospital Nykobing Falster Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Bonato","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Roskilde Hospital Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5559-2101","authenticated-orcid":false,"given":"Kia Schultz","family":"Dungu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Health Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9656-1552","authenticated-orcid":false,"given":"Anja","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Health Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2023-298X","authenticated-orcid":false,"given":"Susanne S\u00f8ndergaard","family":"Kappel","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Paediatric Intensive Care Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"},{"name":"Department of Biotechnology and Biomedicine Technical University of Denmark Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2093-5909","authenticated-orcid":false,"given":"Ulrikka","family":"Nygaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Pediatrics and Adolescent Health Copenhagen University Hospital, Rigshospitalet Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-211X","authenticated-orcid":false,"given":"Stine","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital North Zealand, Hilleroed Hilleroed 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L.","year":"2025","journal-title":"Early Human Development"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/INF.0000000000003400","article-title":"Postnatal Cytomegalovirus Infection of Preterm and Very\u2010Low\u2010Birth\u2010Weight Infants Through Maternal Breast Milk: Does It Matter?","volume":"41","author":"Bimboese P.","year":"2022","journal-title":"Pediatric Infectious Disease Journal"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1093\/cid\/ciw394","article-title":"Incidence, Risk Factors, and Morbidity of Acquired Postnatal Cytomegalovirus Infection Among Preterm Infants Fed Maternal Milk in a Highly Seropositive Population","volume":"63","author":"Martins\u2010Celini F. 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G.","year":"2019","journal-title":"JAMA Pediatrics"},{"key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"e70076","DOI":"10.1111\/ped.70076","article-title":"Breast Milk Pasteurization for Preventing Cytomegalovirus Infection: A Preliminary Study in a Japanese Perinatal Center","volume":"67","author":"Uho S.","year":"2025","journal-title":"Pediatrics International"},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1093\/cid\/ciy945","article-title":"Short\u2010Term Pasteurization of Breast Milk to Prevent Postnatal Cytomegalovirus Transmission in Very Preterm Infants","volume":"69","author":"Bapistella S.","year":"2019","journal-title":"Clinical Infectious Diseases"},{"key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1038\/s41372-021-01129-z","article-title":"Transmission of Cytomegalovirus in Fresh and Freeze\u2013Thawed Mother's Own Milk to Very Preterm Infants: A Cohort Study","volume":"41","author":"Volder C.","year":"2021","journal-title":"Journal of Perinatology"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1056\/NEJMoa1006561","article-title":"Saliva Polymerase\u2010Chain\u2010Reaction Assay for Cytomegalovirus Screening in Newborns","volume":"364","author":"Boppana S. B.","year":"2011","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_10_32_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcv.2025.105800","article-title":"Universal Screening for Congenital Cytomegalovirus Infection Using Saliva From the Neonate","volume":"178","author":"Halwachs\u2010Baumann G.","year":"2025","journal-title":"Journal of Clinical Virology"},{"key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1097\/INF.0000000000003671","article-title":"Breast Milk and Saliva for Postnatal Cytomegalovirus Screening Among Very Low Birth Weight Infants","volume":"41","author":"Mukhopadhyay S.","year":"2022","journal-title":"Pediatric Infectious Disease Journal"},{"key":"e_1_2_10_34_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jcv.2014.06.002","article-title":"Urine Is Superior to Saliva When Screening for Postnatal CMV Infections in Preterm Infants","volume":"61","author":"Gunkel J.","year":"2014","journal-title":"Journal of Clinical Virology"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70779","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70779","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:32:30Z","timestamp":1790397150000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":33,"alternative-id":["10.1111\/apa.70779"],"URL":"https:\/\/doi.org\/10.1111\/apa.70779","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"assertion":[{"value":"2026-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"apa.70779"}}