Associations Between Human Milk Oligosaccharides at 1 Month and Infant Development Throughout the First Year of Life in a Brazilian Cohort.

BACKGROUND: Human milk oligosaccharides (HMOs) are unconjugated glycans associated with infant health and development. OBJECTIVES: To investigate the associations between HMO concentrations at 1 month and infant development throughout the first year of life. METHODS: A prospective cohort of Brazilian women between 18-40 years of age and their infants was studied from baseline (between 28-35 gestational weeks) and followed at 1 (n = 73), 6 (n = 51), and 12 months (n = 45). A total of 19 HMOs were quantified by HPLC with fluorescence detection. Infant development was evaluated by the Brazilian Ages and Stages Questionnaire. A directed acyclic graph was used to define the minimally sufficient adjustment (gestational age at birth, gestational weight gain, prepregnancy BMI, maternal age, parity, and the mode of breastfeeding at 1 month). Cox regression models with HRs and Benjamini-Hochberg multiple corrections were performed to estimate associations of HMOs with the cumulative risk of inadequate development for 5 developmental domains or for ≥2 developmental domains in all women and in the subset of secretor women (defined as the presence or near absence of 2'-fucosyllactose and lacto-N-fucopentaose I). RESULTS: The multivariate models with multiple corrections revealed an inverse association between lacto-N-tetrose (LNT) and the risk of inadequate development for personal-social skills (0.06; 95% CI: 0.01-0.76) and for ≥2 developmental domains (0.06; 95% CI: 0.01-0.59). The secretor mothers analysis also showed inverse associations with slightly different results for personal-social skills (0.09; 95% CI: 0.02-0.84) and ≥2 developmental domains (0.05; 95% CI: 0.01-0.70). CONCLUSIONS: Higher concentrations of LNT HMOs in Brazilian women are associated with their infants being less likely to be at risk of inadequate development for personal-social skills or for ≥2 developmental domains during the first year of life.

Factors associated with longitudinal changes in B-vitamin and choline concentrations of human milk.

BACKGROUND: Little is known regarding the associations between maternal factors and B-vitamin and choline concentrations in early milk and the trajectories of these vitamins during lactation. OBJECTIVES: In this hypothesis-generating study, we modeled the association between maternal and offspring factors and longitudinal changes in milk B-vitamin and choline concentrations throughout lactation. METHODS: A hundred women were studied in a prospective birth cohort and milk samples from 52 women were collected at 2-8 d, 76 women at 28-50 d, and 42 women at 88-119 d postpartum. Maternal dietary intake during pregnancy and lactation was assessed by an FFQ. Linear mixed-effects models with interaction terms were used to evaluate changes in milk B-vitamin and choline concentrations over time based on maternal factors and the early postpartum concentrations of these micronutrients. RESULTS: The women with higher early postpartum milk concentrations of niacin (ßinteraction = -0.02; SE = 0.00; P < 0.001), pantothenic acid (ßinteraction = -0.10; SE = 2.56; P < 0.001), vitamin B-12 (ßinteraction= -0.10; SE = 0.03; P < 0.001), and choline (ßinteraction= -0.90; SE = 0.18; P < 0.001) exhibited a decrease in their concentrations throughout lactation. The participants with overweight and obesity prepregnancy experienced an increase in milk vitamin B-12 concentrations over time (ßinteraction = 0.04; SE = 0.02; P = 0.06). In contrast, a decrease in vitamin B-12 concentration was observed among women with vitamin B-12 intake below the RDA during pregnancy (ßinteraction= -0.08; SE = 0.05; P = 0.07). The women with niacin intake below the RDA during lactation experienced an increase in milk concentrations over time (ßinteraction = 0.01; SE = 0.01; P = 0.03). A gestational age at birth >40 wk was associated with an increase in milk choline concentration throughout lactation (ßinteraction = 0.54; SE = 0.16; P< 0.01). CONCLUSIONS: Changes in B-vitamin and choline concentrations in human milk over time may be associated with the early concentrations of these micronutrients in milk, maternal prepregnancy BMI, dietary intake, and gestational age at delivery.

Maternal plasma folate concentration is positively associated with serum total cholesterol and low-density lipoprotein across the three trimesters of pregnancy.

Increased first-trimester low-density lipoprotein (LDL-C) concentration has been associated with adverse pregnancy outcomes, such as gestational diabetes. The B vitamins folate, B-6, and total B-12 are key for the methyl group-dependent endogenous synthesis of phosphatidylcholine, which is needed for lipoprotein synthesis, e.g., very low-density lipoprotein (VLDL), the precursor of circulating LDL-C. Maternal B-vitamin concentration usually declines across trimesters. Whether changes in maternal B-vitamin concentrations are associated with total cholesterol (TC), triglycerides (TG), and lipoprotein concentrations is unknown. Therefore, we explored the association between plasma folate, vitamin B-6 in the form of pyridoxal 5'-phosphate (PLP), and total B-12 with serum TC, LDL-C, HDL-C, and TG concentrations across trimesters. This secondary analysis used data of a prospective pregnancy cohort study included apparently healthy adult women (n = 179) from Rio de Janeiro, Brazil. The biomarkers were measured in fasting blood samples collected at 5-13, 20-26, and 30-36 weeks of gestation. The associations between B vitamins and lipid concentrations across trimesters were explored using linear mixed-effect models. Among B vitamins, only plasma folate was positively associated with TC (ß = 0.244, 95% CI 0.034-0.454) and LDL-C (ß = 0.193, 95% CI 0.028-0.357) concentrations. The positive relationship of maternal folate and TC and LDL-C concentrations may indicate the importance of folate as a methyl donor for lipoprotein synthesis during pregnancy.

Sleep duration of 24 h is associated with birth weight in nulli- but not multiparous women.

OBJECTIVES: This study aimed to evaluate the association between nightly, napping, and 24-h sleep duration throughout pregnancy and birth weight z-score among nulli- and multiparous women. METHODS: Nightly,napping, and 24-h sleep duration and birth weight z-score (calculated on thebasis of the International Fetal and Newborn Growth Consortium for the 21st century standards) were studied in a cohort of 176 pregnant women from Brazil. Linear mixed-effect analyses were performed to assess the longitudinal evolution of sleep duration and the best unbiased linear predictors of the random coefficients were estimated. The best unbiased linear predictor estimates of sleep duration intercept and slope were included in the linear regression models with birth weight z-score as the outcome. RESULTS: The mean hours of nightly sleep decreased during pregnancy in nulliparous women (ß = -0.55; 95% confidence interval [CI], -0.83 to -0.27) but the decrease was not statistically significant in multiparous women (ß = -0.19; 95% CI, -0.30 to 0.01). Twenty-four hour sleep duration decreased during pregnancy in both multiparous (ß = -0.50; 95% CI, -0.76 to -0.25) and nulliparous women (ß = 0.77; 95% CI, -1.06 to -0.48). Napping sleep duration did not change in either group. Among the nulliparous women, both first-trimester 24-h sleep duration and its change throughout pregnancy were inversely associated with birth weight (ß = -0.44; 95% CI, -0.68 to -0.21; ß = -1.75; 95% CI, -3.17 to -0.30, respectively). No associations were detected in multiparous women for nightly and napping sleep duration. CONCLUSIONS: Nulliparous women with greater decreases in sleep duration throughout their pregnancy gave birth to newborns with lower birth weight z-scores.