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Preterm Birth and Biomarkers of Environmental Enteric Dysfunction among Infants in Tanzania
Author(s) -
Liu Enju,
Manji Karim P,
McDonald Christine M,
Gosselin Kerri,
Kisenge Rodrick,
Fawzi Wafaie W,
Gewirtz Andrew T,
Duggan Christopher P
Publication year - 2017
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.31.1_supplement.649.7
Subject(s) - medicine , gestational age , flagellin , confounding , gestation , pregnancy , weaning , obstetrics , physiology , biology , genetics , receptor
Objective To examine the relationship between preterm birth and biomarkers of environmental enteric dysfunction (EED) among infants. Methods We performed a longitudinal study among a subset of Tanzanian children (n=590) who were enrolled in a micronutrient supplementation trial at age 6 weeks. Blood samples were collected at 6 weeks, 6 months, and 12 months to test for biomarkers of EED (antibodies to lipopolysaccharide (anti‐LPS) and flagellin (anti‐flagellin)). Longitudinal data analysis strategy (proc mixed in SAS) was used to examine the association between preterm birth and EED biomarkers. We adjusted for potential confounders including maternal age, maternal education, maternal middle arm circumference, daily food expenditure, household wealth, infant sex, and delivery by cesarean section. Tukey‐Kramer methods were used to adjust for multiple comparisons. Results 56 (9.5%) infants were born preterm (defined as gestational age <37 weeks). Serum concentrations of all EED biomarkers increased over time (P trend<0.001). In multivariate analysis, at age 6 weeks, preterm infants had significantly higher serum concentrations of anti‐flagellin IgG (adjusted mean: 0.67 vs 0.49, p<0.01), anti‐flagellin IgA (0.45 vs 0.29, P<0.01), anti‐LPS IgG (1.05 vs. 0.78, P<0.01), anti‐LPS IgA (0.62 vs 0.42, p<0.01) compared to full‐term infants. At follow‐up (6 and 12 months of age), these differences did not persist ( figure 1). Conclusion Tanzanian infants born at < 37 weeks gestational age had significantly higher serum concentrations of four biomarkers of EED at 6 weeks of age, compared to full term infants. These differences did not persist later in infancy. Our data suggest that preterm infants may be uniquely susceptible to EED, and that this gastrointestinal dysfunction may have implications for growth and health outcomes in infancy and later. More efforts should be made to identify maternal, environmental, and dietary determinants of EED biomarkers from pregnancy to early childhood. Support or Funding Information Support for this effort was provided jointly by NIH (grants R01 HD048969 and K24 DK104676) and the Feed the Future Innovation Lab for Nutrition which is funded by the United States Agency for International Development (USAID)