The Role of Maternal Secretor Status and Human Milk Oligosaccharides on Early Childhood Development: A Systematic Review and Meta-Analysis.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Breastfeeding Medicine Pub Date : 2024-06-01 Epub Date: 2024-04-05 DOI:10.1089/bfm.2023.0274
Martin M Mulinge, Hellen K Abisi, Hellen M Kabahweza, Lydia Okutoyi, Dalton C Wamalwa, Ruth W Nduati
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引用次数: 0

Abstract

Background: Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. Aims: To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. Study Design: A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. Results: The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, I2 = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; p = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. Conclusions: According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.

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母体分泌状态和母乳低聚糖对儿童早期发育的作用:系统回顾与元分析》。
背景:母乳是婴儿营养的黄金标准,可根据需要提供营养和生物活性分子,以支持婴儿的最佳生长和认知发展。越来越多的证据表明,母乳低聚糖(HMOs)与这些儿童早期发育里程碑有关。目的:总结和归纳有关 HMO 与婴儿大脑发育、身体生长和认知发展的证据。此外,通过荟萃分析比较分泌和非分泌母亲体内的 HMO 浓度。研究设计:根据 PRISMA 声明进行了系统综述和荟萃分析。该综述使用了三个数据库(PubMed、Scopus 和 Web of Science),仅限于 2000 年至 2023 年 6 月 30 日期间发表的英文文章。结果:初步检索共获得 245 篇文章,其中 27 篇被纳入系统综述,12 篇被纳入荟萃分析。荟萃分析表明,研究之间存在很大的异质性,I2 = 97.3%。汇总效应为 0.21(95% CI:-0.41 至 0.83;p = 0.484),表明分泌物较多者的 HMO 浓度较高,但这一差异在统计学上并不显著。一个月大时,2'FL、3FL 和 3'SL 在大脑成熟过程中起着重要作用,因此在认知发展过程中起着关键作用。分泌者会产生更高浓度的 2'FL 和 3'SL,这也是分泌者母亲对婴儿有益的原因。生长速度与岩藻糖基化和硅烷基化 HMO 的浓度相关,浓度越低,发育越迟缓。结论:根据系统综述文章中的证据,HMO 对儿童的早期发育至关重要,但其影响程度取决于母亲的分泌状况。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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