Maternal and infant predictors of human milk macronutrient and energy concentrations in rural Bangladesh: an observational cohort study.

Background: Human milk macronutrient (protein, fat, and carbohydrate) and energy concentrations vary based on maternal and infant factors and time postpartum.

Objective: To determine the change in milk macronutrient and energy concentrations from approximately 2 to 5 months postpartum and identify factors associated with this variation among a lactation cohort in Bangladesh.

Methods: In this prospective observational lactation cohort in rural Sylhet, Bangladesh, we collected hand-expressed mid-feed human milk samples and analyzed macronutrient concentrations using mid-infrared spectroscopy.

Continuous Glucose Monitoring among Infants Born Very Preterm: Evidence for Accuracy in Neonatal Intensive Care.

Objective: To evaluate the accuracy of a device for continuous glucose monitoring (CGM) among infants born preterm admitted to the neonatal intensive care unit.

Study Design: We analyzed paired CGM sensor glucose (SG) and point-of-care blood glucose (BG) measurements collected in infants born at ≤32 weeks of gestation or with a birth weight ≤1500 g. CGM was initiated within 48 hours from birth and maintained for 5 days.

Risk of Neonatal Hypoglycemia in Infants of Mothers With Gestational Glucose Intolerance.

Objective: To examine the relationship between gestational glucose intolerance (GGI) and neonatal hypoglycemia.

Research Design And Methods: This was a secondary analysis of 8,262 mother-infant dyads, with delivery at two hospitals between 2014 and 2023. We categorized maternal glycemic status as normal glucose tolerance (NGT), GGI, or gestational diabetes mellitus (GDM).

Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial.

Background/objective: Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy.

Lactoferrin intake from maternal milk during the neonatal hospitalization and early brain development among preterm infants.

Background: Lactoferrin is an immuno-modulatory nutrient in human milk that may be neuroprotective.

Methods: In 36 infants born <32 weeks' gestation, we sampled human milk at 14 and 28 days of chronologic age and measured lactoferrin by electrochemiluminescence multiplex immunoassay. Using 3T quantitative brain magnetic resonance imaging scans obtained at term equivalent, we estimated total and regional brain volumes.

Gestational Glucose Intolerance and Birth Weight-Related Complications.

Objective: To evaluate the risks of large-for-gestational-age birth weight (LGA) and birth weight-related complications in pregnant individuals with gestational glucose intolerance, an abnormal screening glucose loading test result without meeting gestational diabetes mellitus (GDM) criteria.

Methods: In a retrospective cohort study of 46,989 individuals with singleton pregnancies who delivered after 28 weeks of gestation, those with glucose loading test results less than 140 mg/dL were classified as having normal glucose tolerance. Those with glucose loading test results of 140 mg/dL or higher and fewer than two abnormal values on a 3-hour 100-g oral glucose tolerance test (OGTT) were classified as having gestational glucose intolerance.

Mediators of the association between maternal body mass index and breastfeeding duration in 3 international cohorts.

Background: Maternal obesity has been associated with shorter breastfeeding duration, but little is known about mediating factors explaining this association. It is important to assess these relationships across diverse populations because breastfeeding is culturally patterned.

Objectives: We investigated the association of prepregnancy maternal body mass index (BMI) with breastfeeding outcomes and potential mediators of this relationship in 3 culturally diverse international cohorts.

The Role of Prenatal Psychosocial Stress in the Associations of a Proinflammatory Diet in Pregnancy With Child Adiposity and Growth Trajectories.

Importance: Prenatal psychosocial stress and nutrition may each program offspring adiposity, an important predictor of lifelong cardiometabolic health. Although increased stress and poor nutrition have been found to co-occur in pregnancy, little is known about their combined longitudinal associations in the offspring.

Objective: To investigate whether the associations of the Dietary Inflammatory Index (DII) with offspring adiposity differ by prenatal stress levels and whether these associations change with age.

Role of lipidomics in assessing the functional lipid composition in breast milk.

Breast milk is the ideal source of nutrients for infants in early life. Lipids represent 2-5% of the total breast milk composition and are a major energy source providing 50% of an infant's energy intake. Functional lipids are an emerging class of lipids in breast milk mediating several different biological functions, health, and developmental outcome.

Maternal Predictors of Breast Milk Plasmalogens and Associations with Infant Body Composition and Neurodevelopment.

Purpose: Ethanolamine-containing plasmalogens (pPEs) are a unique class of breastmilk (BM) glycerophospholipids containing a vinyl-ether at the sn-1 and a polyunsaturated fatty acid (PUFA) at the sn-2 position of the glycerol moiety. pPEs are present in the milk fat globule membrane, accumulate in the infant brain, and have been implicated in infant development. The study objectives were to: (1) describe the composition of BM pPEs and the variation in monomers at both the sn-1 and sn-2 positions; and (2) quantify the associations between BM pPEs and maternal predictors (body mass index, race, dietary fatty acid intake, gestational age at birth, and days' postpartum).

Breast Milk from Non-Obese Women with a High Omega-6 to Omega-3 Fatty Acid Ratio, but Not from Women with Obesity, Increases Lipogenic Gene Expression in 3T3-L1 Preadipocytes, Suggesting Adipocyte Dysfunction.

Maternal body mass index is associated with breast milk (BM) fatty acid composition. This study investigated the effects of BM omega (n)-6:n-3 polyunsaturated fatty acids (PUFAs) from non-obese women and women with obesity on the process of adipogenesis in 3T3-L1 preadipocytes. BM samples were collected from non-obese women (BMNO) and women with obesity (BMO) at one month postpartum.

Plasma-glycated CD59 as an early biomarker for gestational diabetes mellitus: prospective cohort study protocol.

Introduction: The significant maternal and neonatal outcomes of gestational diabetes mellitus (GDM) make it a major public health concern. Mothers with GDM are at greater risk of pregnancy complications and their offspring are at higher risk of diabetes and obesity. Currently, GDM is diagnosed with glucose load methods which are time-consuming and inconvenient to administer more than once during pregnancy; for this reason, there is a recognised need for a more accurate and simpler test for GDM.

Maternal Diet, Infection, and Risk of Cord Blood Inflammation in the Bangladesh Projahnmo Pregnancy Cohort.

Inflammation may adversely affect early human brain development. We aimed to assess the role of maternal nutrition and infections on cord blood inflammation. In a pregnancy cohort in Sylhet, Bangladesh, we enrolled 251 consecutive pregnancies resulting in a term livebirth from July 2016-March 2017.

Clinical Characteristics and Breastfeeding Outcomes in Term Dyads Following In-Hospital Supplementation with Pasteurized Donor Human Milk or Formula.

Pasteurized donor human milk (PDHM) supplementation for healthy infants is an emerging practice. Little is known about demographics or breastfeeding outcomes for dyads whose mothers choose PDHM versus formula. To identify relationships between in-hospital supplementation choice and (1) dyad characteristics and breastfeeding intent, and (2) breastfeeding outcomes at 1 month.

Maternal diet in pregnancy is associated with differences in child body mass index trajectories from birth to adolescence.

Background: Nutrition in pregnancy and accelerated childhood growth are important predictors of obesity risk. Yet, it is unknown which dietary patterns in pregnancy are associated with accelerated growth and whether there are specific periods from birth to adolescence that are most sensitive to these associations.

Objectives: To examine the extent to which 3 dietary indices in pregnancy [Dietary Inflammatory Index (DII), Alternate Healthy Eating Index for Pregnancy (AHEI-P), and Mediterranean Diet Score (MDS)] are associated with child BMI z-score (BMI-z) trajectories from birth to adolescence.

Effect of Omega-3 Supplementation in Pregnant Women with Obesity on Newborn Body Composition, Growth and Length of Gestation: A Randomized Controlled Pilot Study.

Maternal obesity, a state of chronic low-grade metabolic inflammation, is a growing health burden associated with offspring adiposity, abnormal fetal growth and prematurity, which are all linked to adverse offspring cardiometabolic health. Higher intake of anti-inflammatory omega-3 (n-3) polyunsaturated fatty acids (PUFA) in pregnancy has been associated with lower adiposity, higher birthweight and longer gestation. However, the effects of n-3 supplementation specifically in pregnant women with overweight and obesity (OWOB) have not been explored.

A Graded Approach to Intravenous Dextrose for Neonatal Hypoglycemia Decreases Blood Glucose Variability, Time in the Neonatal Intensive Care Unit, and Cost of Stay.

Objective: To determine associations between a graded approach to intravenous (IV) dextrose treatment for neonatal hypoglycemia and changes in blood glucose (BG), length of stay (LOS), and cost of care.

Study Design: Retrospective cohort study of 277 infants born at ≥35 weeks of gestation in an urban academic delivery hospital, comparing the change in BG after IV dextrose initiation, neonatal intensive care unit (NICU) LOS, and cost of care in epochs before and after a hospital protocol change. During epoch 1, all infants who needed IV dextrose for hypoglycemia were given a bolus and started on IV dextrose at 60 mL/kg/day.

Improving the uptake of Kangaroo Mother Care in neonatal units: A narrative review and conceptual framework.

Kangaroo Mother Care is a beneficial intervention for high-risk infants; however, global uptake is lacking. Recent systematic reviews have collated the numerous studies that identify diverse barriers and enablers to the use of Kangaroo Mother Care. In this narrative review, we combine the findings of these systematic reviews with more recent studies to propose a conceptual framework, encompassing factors that may affect the initiation and maintenance of Kangaroo Mother Care in neonatal units.

Role of maternal glucose metabolism in the association between maternal BMI and neonatal size and adiposity.

Background/objective: One potential mechanism by which maternal obesity impacts fetal growth is through hyperglycemia below the threshold for gestational diabetes. Data regarding which measures of maternal glucose metabolism mediate this association is sparse. The objectives of this study were to (i) quantify the associations of maternal pre-pregnancy body mass index (BMI) with neonatal size and adiposity and (ii) examine the role of markers of maternal glucose metabolism as mediators in these associations.

The impact of maternal obesity and breast milk inflammation on developmental programming of infant growth.

Background: Little is known about how maternal obesity impacts breast milk (BM) composition and how BM composition may impact growth. We sought to determine the role of maternal body mass index (BMI) on BM inflammatory and oxidative stress markers and to delineate the role of these BM markers on infant growth.

Methods: This was a secondary analysis of 40 mother-infant dyads.

Type of feeding provided with dextrose gel impacts hypoglycemia outcomes: comparing donor milk, formula, and breastfeeding.

Objective: Examine neonatal hypoglycemia (NH) outcomes based on type of feeding provided with first dextrose gel.

Study Design: Retrospective matched cohort study of 99 infants ≥35 weeks gestational age who received dextrose gel in combination with breastfeeding, formula feeding, or donor milk feeding for NH. The exposure was feeding type.