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The Impact of Gestational Endocrine Disorders of Breast Milk Fat Characteristics and Infant Growth
Author(s) -
Ellsworth Lindsay,
Harman Emma,
Anderson Clare,
Craig Annmarie,
John Elizabeth,
Yeh Joanna,
Gregg Brigid
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.650.23
Subject(s) - gestational diabetes , medicine , pregnancy , polyunsaturated fatty acid , endocrinology , breast milk , body mass index , polycystic ovary , physiology , type 2 diabetes , diabetes mellitus , fatty acid , obstetrics , insulin resistance , gestation , biology , biochemistry , genetics
Background Maternal endocrine disorders are increasingly prevalent co‐morbidities during pregnancy with the potential to impact maternal health, fetal development, newborn health and long‐term childhood outcomes. Limited data exists on changes in breast milk composition associated with maternal metabolic disease in pregnancy. Based on existing data from animal models, we hypothesize that maternal alterations in insulin signaling leads to changes in milk fat content and fatty acid profile with an increased ratio of omega‐6 long chain polyunsaturated fatty acids to omega‐3 long chain polyunsaturated fatty acids and reduced monounsaturated fatty acid content. Objective Our study objective is to determine if maternal metabolic disease leads to changes in milk composition that then impacts infant growth trajectory. Methods We are in the enrollment phase of a large prospective cohort study of mothers with gestational diabetes mellitus (GDM), type 1 diabetes mellitus, type 2 diabetes mellitus, obesity, and polycystic ovary syndrome (PCOS) in comparison to healthy mothers. This study has been approved by the University of Michigan Institutional Review Board. We will perform metabolomic analysis on human milk to evaluate fatty acid content through mass spectrometry. We will evaluate mammary epithelial cells for protein and mRNA levels of lipogenic enzymes to correlate to milk fat composition. We will determine if maternal factors including metabolic disease diagnosis, body mass index, and glycemic control influence milk composition. We will then correlate infant growth trajectory with milk fat alterations. Results We have enrolled 29 mother‐baby pairs including 16 healthy, 6 obese, 5 PCOS, and 2 GDM mothers. Mothers had a mean maternal age of 30 years old, mean gestation age of 40 weeks, and 31% delivered by C‐section. In our existing cohort, growth from birth to 2 months does not reveal a significant difference in weight or length however there is an indication that infant head circumference may differ by maternal metabolic disease category by 2‐way ANOVA testing. Breast milk composition analysis is currently underway. Conclusions Additional recruitment is ongoing with the goal of expansion of the diabetes mellitus cohorts in order to evaluate for significant differences in breast milk fat composition and infant growth trajectory in the setting of maternal metabolic disease. Support or Funding Information Percy J. Murphy, M.D. and Mary C. Murphy, R.N. Endowed Children's Research Fund