Fat content of colostrum and carbohydrate content of mature milk obtained from mothers with advanced age are elevated compared with those of younger mothers. Moreover, there is a positive correlation between maternal age and carbohydrate content in mature milk. The biological significance of our findings is yet to be determined.
Study Objectives: Body position during sleep has been related to breathing in adults with obstructive sleep apnea (OSA). While sleep-disordered breathing is common, little information is available on the relation between sleep position and maternal breathing in pregnancy. We examined associations between the supine position, maternal breathing, and perinatal outcomes. Methods: Women with a singleton, uncomplicated pregnancy were recruited and underwent an ambulatory overnight sleep study between 33 to 36 weeks using the Watch-PAT device. Their medical records were also reviewed. Results: A total of 148 pregnant women were recruited (mean age: 33 ± 4 years; mean body mass index: 27.6 ± 4.0 kg/m 2 ). They spent approximately one-half of their sleeping time in a supine position. The group's mean apnea-hypopnea index (AHI) was 3.6 events/h in the supine position and 2.9, 2.6, and 2.1 events/h for the prone, right, and left positions, respectively. Median AHI and oxygen desaturation index were higher and SpO 2 nadir was lower in the supine versus nonsupine position (P <.0001, P <.0001, and P = .006, respectively). Peripheral oxygen saturation nadir was associated with the percentage of time spent sleeping in the supine position (P =.02). No correlations were found between supine sleep position and perinatal outcomes. There were no differences in the distributions of body positions between women with and those without OSA. Conclusions: Women in the third trimester of pregnancy with or without OSA spent large proportions of sleeping time in a supine position. Supine position was associated with more respiratory events and more and deeper oxygen desaturation events. They were not associated with perinatal outcomes.
Sleep-disordered breathing (SDB) during pregnancy has been linked to adverse fetal outcomes. Since the intrauterine milieu plays a critical role in childhood growth, we explored the interactions between maternal SDB and offspring growth and adiposity patterns during infancy. Fifty-eight healthy women with uncomplicated pregnancies underwent an objective sleep study and laboratory evaluation during the third trimester, their offspring underwent a 3-year growth surveillance. The 14 (24.1%) women with SDB had a higher body mass index (BMI) (P = 0.003), elevated C-reactive protein levels (P = 0.003), and decreased HDL-cholesterol levels (P = 0.009) than the women without SDB. A general linear model evaluated the interactions between maternal SDB and offspring growth and adiposity measurements after controlling for gestational age and maternal and paternal BMIs. The offspring of mothers with SDB had a significantly smaller head circumference at birth (P = 0.004), with a distinctive pattern of catchup growth by the end of the first year of life (P = 0.018). Their growth pattern was distinguished by compromised birth weight-to-length, rapid catch-up growth, and an increase in both weight-to-length and triceps thickness by the age of three (P < 0.001 and P = 0.001, respectively). Our findings suggest that maternal SDB during pregnancy affects head circumference growth and adiposity acquisition from birth through infancy.
Aim. To study longitudinal macronutrient concentrations of colostrum and mature human milk (HM) and test the hypothesis that colostrum concentration of a given macronutrient might predict the concentration of this macronutrient in mature milk. Methods. We collected samples of expressed HM obtained from mothers of full-term infants. Each mother contributed 2 samples of HM-the first during 72 hours after labor (colostrum) and the second after 14 days. Macronutrient contents of the samples were measured using infrared transmission spectroscopy. Results. In all, 57 women were recruited. Only 44 of them gave both colostrum and 14-day samples. The energy, fat, and carbohydrate content of mature milk was significantly higher than that in colostrum, whereas the opposite was found for protein content. There was no significant relationship between maternal weight for height and protein, fat, or lactose content at any stage. Energy, fat, and protein content in colostrum did not correlate with values in mature milk. In contrast, the lactose content in mature milk was highly correlated with that of colostrum (R 2 = 0.47, P < .0001). Conclusion. Energy, fat, and protein content in colostrum do not predict values in mature milk. In contrast, lactose content in mature milk is highly correlated with that in colostrum.
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