426 - Associations of Maternal Inflammatory States and Human Milk Composition in Mothers of Preterm Infants

Poster Number: 426
Publication Number: 426.302

Erin Landau-Crangle, The Hospital for Sick Children, Toronto, ON, Canada; Deborah L. O'Connor, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Sharon Unger, Sinai Health, Toronto, ON, Canada; Kathryn Hopperton, Health Canada, Ottawa, ON, Canada; Emily Somerset, University health network, Toronto, ON, Canada; Hadar Nir, University of Toronto, Kefar Shmuel, HaMerkaz, Israel; Rebecca Hoban, The Hospital for Sick Children, Toronto, ON, Canada

Background: Overweight/obesity (ow/ob) is increasing in prevalence in pregnant women, and is associated with other pro-inflammatory conditions such as pre-eclampsia. Pre- and peri-pregnancy pro-inflammatory states influence fetal metabolic programming and may impact neurodevelopment. Mother’s own milk (MOM) is the gold standard for feeding preterm infants; data is lacking if mothers with inflammatory conditions who deliver preterm infants have MOM with higher inflammatory markers or pro-inflammatory fatty acid (FA) profiles.

Objective: To study associations of maternal inflammatory conditions (pre-pregnancy ow/ob, diabetes, chorioamnionitis [chorio], PTL, premature rupture of membranes, pre-eclampsia, and caesarian delivery) and inflammatory markers and FAs in MOM from mothers of preterm infants.
 

Design/Methods: This is a secondary analysis of MOM samples collected in OptiMoM, a triple-blind randomized clinical trial in infants born < 1250 g (NCT02137473).  Longitudinally collected MOM samples were analyzed for cytokines and inflammatory markers (C-reactive protein [CRP], IFN-Ɣ, IL-10, IL-1b, IL-1ra, IL-6, IL-8, TNF-α) and FA composition (omega-6:omega-3 ratio, Arachidonic acid [ARA], Docosahexaenoic acid [DHA] level) at baseline and over time.  The above inflammatory conditions were assessed individually; subsets were also grouped: Healthy group 1 (normal BMI, no chorio) and Healthy group 2 (normal BMI, no chorio, no pre-eclampsia). Regression analysis was performed to study potential impact of each maternal inflammatory condition (or group of conditions) on MOM inflammatory markers and FA components at baseline (day 5=earliest day majority of samples available) and during follow-up (postpartum day 5 through 54) using generalized estimating equations. Significance was set at p< 0.05.

Results: Subject characteristics are in Table 1.   CRP in MOM was higher in ow/ob mothers and lower in mothers in the 2 “healthy groups” at baseline (Table 2).  MOM IL-8 levels were lower with chorio (p=0.04) and PTL (p=0.05) at baseline. No significant associations were found for other individual or grouped inflammatory conditions for other MOM inflammatory markers nor FA profiles at baseline (day 5).Conclusion(s): Ow/ob mothers of preterm infants have higher MOM CRP; those with fewer inflammatory diagnoses have lower MOM CRP. There was no association between FA profiles or most other inflammatory markers and maternal inflammatory diagnoses at baseline.  Further studies are needed to determine potential associations or ramifications of MOM CRP in vulnerable preterm infants.
Erin Landau-Crangle CVCV_Erin_Landau-Crangle_2022_01_05.pdf
Table 2: Regression Results for C-Reactive Protein