Maternal Nutritional Status During Pregnancy and Infant Immune Response to Routine Childhood Vaccinations

Obanewa, Olayinka Aderopo; Newell, Marie‐Louise

doi:10.2217/fvl-2017-0021

Cited by 22 publications

(21 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent review of the effects of maternal nutritional status on infant vaccine responses concluded that maternal macro- and micronutrient deficiency during pregnancy is likely to impair infant responses to vaccines, even in the presence of nutrient supplementation ( 34 ).…”

Section: Vaccine Responses In Hiv-infected Infantsmentioning

confidence: 99%

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

2018

Self Cite

View full text Add to dashboard Cite

The success of prevention of mother to child transmission programs over the last two decades has led to an increasing number of infants who are exposed to human immunodeficiency virus (HIV), but who are not themselves infected (HIV-exposed, uninfected infants). Although the morbidity and mortality among HIV-exposed, uninfected infants is considerably lower than that among HIV-infected infants, they may remain at increased risk of infections in the first 2 years of life compared with their HIV-unexposed peers, especially in the absence of breastfeeding. There is some evidence of immunological differences in HIV-exposed, uninfected infants, which could play a role in susceptibility to infection. Cytomegalovirus (CMV) may contribute to the increased immune activation observed in HIV-exposed, uninfected infants. Infants born to HIV-infected women are at increased risk of congenital CMV infection, as well as early acquisition of postnatal CMV infection. In infants with HIV infection, CMV co-infection in early life is associated with higher morbidity and mortality. This review considers how HIV infection, HIV exposure, and CMV infection affect infant responses to vaccination, and explores possible immunological and other explanations for these findings. HIV-infected infants have lower vaccine-induced antibody concentrations following tetanus, diphtheria, pertussis, hepatitis B, and pneumococcal vaccination, although the clinical relevance of this difference is not known. Despite lower concentrations of maternal-specific antibody at birth, HIV-exposed, uninfected infants respond to vaccination at least as well as their HIV-unexposed uninfected peers. CMV infection leads to an increase in activation and differentiation of the whole T-cell population, but there is limited data on the effects of CMV infection on infant vaccine responses. In light of growing evidence of poor clinical outcomes associated with CMV infection in HIV-exposed, uninfected infants, further studies are particularly important in this group. A clearer understanding of the mechanisms by which maternal viral infections influence the developing infant immune system is critical to the success of maternal and infant vaccination strategies.

show abstract

Section: Vaccine Responses In Hiv-infected Infantsmentioning

confidence: 99%

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, we want to assess the impact of these interventions, if any, on inflammatory biomarkers in both stool and blood, iron deficiency, and the composition of breastmilk. The study results will additionally enable us to examine the changes in infant stool microbiota that play a substantial role in inflammation, immune development, enteropathy, and the nutritional-antimicrobial causal pathway [ 20 – 23 ]. Therefore, a gap exists in the current knowledge in the context of standard of care being “only nutrition counseling to the undernourished lactating women”; whether a high-dose BEP supplements (16–21 g of protein per day) during lactation is beneficial for the infant’s growth has yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

Nutritional support for lactating women with or without azithromycin for infants compared to breastfeeding counseling alone in improving the 6-month growth outcomes among infants of peri-urban slums in Karachi, Pakistan—the protocol for a multiarm assessor-blinded randomized controlled trial (Mumta LW trial)

Muhammad¹,

Shafiq²,

Nisar

et al. 2020

Trials

View full text Add to dashboard Cite

Background: Globally, 45% of under-five deaths are either directly or indirectly attributable to malnutrition, and most of these deaths are in low-and middle-income countries (LMICs). Children are particularly vulnerable in the first 6 months of life. An estimated 4.7 million infants under the age of 6 months are moderately wasted, whereas 3.8 million are severely wasted. Although the children of malnourished women have an increased risk of stunting and wasting, there is little information on this issue. Methods: This is a community-based, open-label, multiarm randomized controlled trial that will include parallel group assignments with a 1:1:1 allocation ratio in low-income squatter settlements in urban Karachi, Pakistan. The women in the control group (control arm) will receive standard counseling only, whereas the lactating women in the first intervention group (intervention arm 1) will receive two sachets of balanced energy protein (BEP) supplementation per day from enrollment until the infant reaches 6 months of age. The lactating women in the second intervention group (intervention arm 2) will receive the same BEP supplementation as those in intervention arm 1 while their babies will also receive a single stat dose (20 mg/kg orally) of azithromycin at 42 days. The primary outcome will be the relative length velocity from 0 to 6 months by intervention arm. The primary analysis will be intention-to-treat analysis. Trial registration: ClinicalTrials.gov NCT03564652. Registered on

show abstract

“…The study will additionally enable us to examine changes in infant stool microbiota which plays a substantial role in in ammation, immune development, enteropathy and in the nutritional -antimicrobial causal pathway. (22,23,24,25). Therefore, an evidence gap exists in the context where standard-of-care is only nutrition counseling to the undernourished lactating women, concerning whether a high dose BEP supplement with 16-21 grams of protein per day during lactation among these women is bene cial to improve the infant's growth or not is yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

Nutritional support for lactating women with or without Azithromycin for infants compared to breast-feeding counselling alone, to improve six-month growth outcomes among infants of peri-urban slums of Karachi, Pakistan – a protocol of multi-arm assessor blinded randomized controlled trial (Mumta LW trial)

Muhammad¹,

Shafiq²,

Nisar³

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundGlobally, 45% of under-five deaths are, directly or indirectly, attributable to malnutrition, most of these deaths are in low- and middle-income countries (LMICs). Children in the first 6 months of life are particularly vulnerable. An estimated 4.7 million infants under the age of 6 months are moderately wasted whereas 3.8 million are severely wasted. Despite the increased risk to a child of a mother with nutritional decompensation, there are discrepancies in guidance in this area. MethodsThis is a community-based, open-label factorial randomized controlled trial, using parallel assignment with 1:1:1 allocation ratio, in low-income squatter settlements of urban Karachi, Pakistan. In the control group (Arm A), women are randomized to standard counseling only; whereas in the first intervention group (Arm B), lactating women receive two sachets of balanced energy-protein (BEP) supplementation per day from enrollment till the infant reaches six months of age, in the second intervention group (Arm C), lactating women receive same BEP as in intervention Arm B while their babies also receive a single stat dose (20mg/kg orally) of azithromycin at 42 days. The primary outcome is relative length velocity from 0 to 6 months by the limb of allocation. The primary analysis will be Intention-to-treat analysisTrial registrationRegistration of the trial is done at ClinicalTrials.gov. NCT03564652, registered on June 21, 2018. Trial registration data is available through https://clinicaltrials.gov/ct2/show/NCT03564652

show abstract

Maternal Nutritional Status During Pregnancy and Infant Immune Response to Routine Childhood Vaccinations

Cited by 22 publications

References 61 publications

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review

Contact Info

Product

Resources

About