Influence of Diabetes during Pregnancy on Human Milk Composition

Peila, Chiara; Gazzolo, Diego; Bertino, Enrico; Cresi, Francesco; Coscia, Alessandra

doi:10.3390/nu12010185

Cited by 54 publications

(54 citation statements)

References 42 publications

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“…In addition, HM composition varies between preterm and term births [69], and whether the relationship between maternal overweight and/or obesity and HM composition could potentially vary in HM from mothers of term and preterm infants is unknown. In addition, the fact that lactating women from overweight and obese groups may also have other metabolic conditions, such as gestational or pre-gestational diabetes, could influence the results, given emerging evidence of differences in HM composition between women with and without diabetes [71]. Almost all studies utilized BMI to classify women as overweight and obese.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

et al. 2020

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Maternal obesity has been associated with changes in the macronutrient concentration of human milk (HM), which have the potential to promote weight gain and increase the long-term risk of obesity in the infant. This article aimed to provide a synthesis of studies evaluating the effects of maternal overweight and obesity on the concentrations of macronutrients in HM. EMBASE, MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, and ProQuest databases were searched for relevant articles. Two authors conducted screening, data extraction, and quality assessment independently. A total of 31 studies (5078 lactating women) were included in the qualitative synthesis and nine studies (872 lactating women) in the quantitative synthesis. Overall, maternal body mass index (BMI) and adiposity measurements were associated with higher HM fat and lactose concentrations at different stages of lactation, whereas protein concentration in HM did not appear to differ between overweight and/or obese and normal weight women. However, given the considerable variability in the results between studies and low quality of many of the included studies, further research is needed to establish the impact of maternal overweight and obesity on HM composition. This is particularly relevant considering potential implications of higher HM fat concentration on both growth and fat deposition during the first few months of infancy and long-term risk of obesity.

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Section: Discussionmentioning

confidence: 99%

The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

et al. 2020

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“…However, it was reported that diabetes mellitus [72][73][74], overweight [75,76] or hypertension [77] of the lactating mother has an impact on the nutritional composition of milk. A summary of the main trends observed in the nutritional composition of mother's milk was presented by Amaral and coworkers [78] as well as the systematic review by Peila and coworkers [79].…”

Section: Maternal Morbidities and Their Impact On Fucosylation Of Diementioning

confidence: 99%

The Impact of Dietary Fucosylated Oligosaccharides and Glycoproteins of Human Milk on Infant Well-Being

Orczyk-Pawiłowicz

Lis-Kuberka

2020

Nutrients

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Apart from optimal nutritional value, human milk is the feeding strategy to support the immature immunological system of developing newborns and infants. The most beneficial dietary carbohydrate components of breast milk are human milk oligosaccharides (HMOs) and glycoproteins (HMGs), involved in both specific and nonspecific immunity. Fucosylated oligosaccharides represent the largest fraction of human milk oligosaccharides, with the simplest and the most abundant being 2′-fucosyllactose (2′-FL). Fucosylated oligosaccharides, as well as glycans of glycoproteins, as beneficial dietary sugars, elicit anti-adhesive properties against fucose-dependent pathogens, and on the other hand are crucial for growth and metabolism of beneficial bacteria, and in this aspect participate in shaping a healthy microbiome. Well-documented secretor status related differences in the fucosylation profile of HMOs and HMGs may play a key but underestimated role in assessment of susceptibility to fucose-dependent pathogen infections, with a potential impact on applied clinical procedures. Nevertheless, due to genetic factors, about 20% of mothers do not provide their infants with beneficial dietary carbohydrates such as 2′-FL and other α1,2-fucosylated oligosaccharides and glycans of glycoproteins, despite breastfeeding them. The lack of such structures may have important implications for a wide range of aspects of infant well-being and healthcare. In light of the above, some artificial mixtures used in infant nutrition are supplemented with 2′-FL to more closely approximate the unique composition of maternal milk, including dietary-derived fucosylated oligosaccharides and glycoproteins.

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“…At the nutritional level, several studies show signi cant changes in breastmilk of diabetic pregnancies through all the lactating phases. For example, altered levels of anti-infective proteins such as lactoferrin, glycosylation of slgA suggesting that glucose dysregulation has consequences that affect macromolecular composition of breastmilk [23].…”

Section: Introductionmentioning

confidence: 99%

Compositional analysis of the bacterial community in colostrum samples from women with gestational diabetes mellitus and obesity

Gámez-Valdez

García-Mazcorro²,

Rincón

et al. 2020

Preprint

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Background. Gestational Diabetes Mellitus (GDM) and obesity are threatening health conditions during pregnancy, as they affect the normal function of multiple systems, including neuro-hormonal networks, and adipose, liver, muscle and placenta. GDM and maternal obesity are main triggers to a vicious cycle of metabolic and cardiovascular diseases perpetuated trans-generationally. One of the first stages of this vicious cycle occurs during early lactation as the infant feeds of “disbalanced” breastmilk microbiota and macromolecule level. Despite the importance of breastmilk microbiota on newborn development, few studies have characterized breastmilk microbiota in association with obesity and GDM. Maternal obesity decreases the diversity of breastmilk microbiota, with increased proportions Staphylococcus compared to Bifidobacterium and Bacteroides. However, the extent to which GDM together with maternal obesity affect breastmilk microbiota is unknown. Here, we applied 16S-rRNA high-throughput sequencing to characterize colostrum microbiota of 43 mothers with exclusive GDM and obesity in order to address the impact of GDM/obesity on breastmilk microbiota.Results. We identified a total of 1,496 amplicon sequence variants (ASVs), being Proteobacteria and Firmicutes the dominant phyla. We found Staphylococcus, Corynebacterium-1, Anaerococcus and Prevotella overrepresented in samples of women with obesity and women with GDM. Population diversity indicators, such as Shannon/Faith phylogenetic index and UniFrac/robust Aitchison distances show distinct microbial composition for GDM (female-newborn subgroup) and obesity (male-newborn subgroup) compared to controls. Finally, Differential abundance analysis showed that Rhodobacteraceae was distinct for GDM and five families (Bdellovibrionaceae, Halomonadaceae, Shewanallaceae, Saccharimonadales and Vibrionaceae) were distinct for obesity groups.Conclusions. Our study indicates that GDM and obesity are related to a higher microbial diversity. Preliminary functional analysis suggests that this could be attributed to overrepresentation of amino acid and carbohydrate metabolism bacterial pathways. However, there is a strong influence of the infant´s gender and the utilization of antibiotics intrapartum. To our knowledge, this study represents the first characterization of the taxonomical changes of colostrum breastmilk in mothers with GDM. We think this study contributes to future design of functional metagenomic studies aiming to understand molecular mechanisms by which breastmilk from mothers with GDM/obesity affect the development and future adult physiology of their suckling infants.

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Influence of Diabetes during Pregnancy on Human Milk Composition

Cited by 54 publications

References 42 publications

The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

The Impact of Maternal Obesity on Human Milk Macronutrient Composition: A Systematic Review and Meta-Analysis

The Impact of Dietary Fucosylated Oligosaccharides and Glycoproteins of Human Milk on Infant Well-Being

Compositional analysis of the bacterial community in colostrum samples from women with gestational diabetes mellitus and obesity

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