Glucocorticoids in preterm human milk

Muelbert, Mariana; Alexander, Tanith; Vickers, Mark H.; Harding, Jane E.; Galante, Laura; Bloomfield, Frank H.; DIAMOND, (for the

doi:10.3389/fnut.2022.965654

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Glucocorticoids in preterm human milk

Mariana Muelbert, Tanith Alexander, Mark H. Vickers, Jane E. Harding, Laura Galante

, Frank H. Bloomfield, (for the DIAMOND study group)

Frontiers in Nutrition, Volume: 9, Start page: 965654

Swansea University Author: Laura Galante

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© 2022 Muelbert, Alexander, Vickers, Harding, Galante and Bloomfield. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
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DOI (Published version): 10.3389/fnut.2022.965654

Abstract

Background: Glucocorticoids (GCs), cortisol and cortisone, are essential regulators of many physiological responses, including immunity, stress and mammary gland function. GCs are present in human milk (HM), but whether maternal and infant factors are associated with HM GC concentration following pr...

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Published in:	Frontiers in Nutrition
ISSN:	2296-861X
Published:	Frontiers Media SA 2022
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URI:	https://cronfa.swan.ac.uk/Record/cronfa68011

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GCs are present in human milk (HM), but whether maternal and infant factors are associated with HM GC concentration following preterm birth is unclear.Materials and methods: HM samples were collected on postnatal day 5 and 10 and at 4 months’ corrected age (4m CA) in a cohort of moderate- and late-preterm infants. GCs in HM were measured by liquid chromatography-tandem mass spectrometry. Relationships between GCs in HM and both maternal and infant characteristics were investigated using Spearman’s correlations and linear mixed models.Results: 170 mothers of 191 infants provided 354 HM samples. Cortisol concentrations in HM increased from postnatal day 5–4m CA (mean difference [MD] 0.6 ± 0.1 ng/ml, p < 0.001). Cortisone concentration did not change across lactation but was higher than cortisol throughout. Compared to no antenatal corticosteroid (ANS), a complete course of ANS was associated with lower GC concentrations in HM through to 4m CA (cortisol: MD –0.3 ± 0.1 ng/ml, p < 0.01; cortisone MD –1.8 ± 0.4 ng/ml, p < 0.001). At 4m CA, higher maternal perceived stress was negatively associated with GC concentrations in HM (cortisol adjusted beta-coefficient [aβ] –0.01 ± 0.01 ng/ml, p = 0.05; and cortisone aβ –0.1 ± 0.03 ng/ml, p = 0.01), whereas higher postpartum depression and maternal obesity were associated with lower cortisone concentrations (aβ –0.1 ± 0.04 ng/ml p < 0.05; MD [healthy versus obese] –0.1 ± 0.04 ng/ml p < 0.05, respectively). There was a weak positive correlation between GC concentrations in HM and gestational age at birth (r = 0.1, p < 0.05). Infant birth head circumference z-score was negatively associated with cortisol concentrations (aβ –0.01 ± 0.04 ng/ml, p < 0.05). At hospital discharge, fat-free mass showed a weak positive correlation with cortisol concentrations (r = 0.2, p = 0.03), while fat mass showed a weak negative correlation with cortisone concentrations (r = –0.25, p < 0.001).Conclusion: The mammary gland appears to protect the infant from cortisol through inactivation into cortisone. Maternal and infant characteristics were associated with concentration of GCs in HM, including ANS, stress and depression scores, obesity, gestational age and infant size. 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spelling	2025-02-12T14:17:53.2778047 v2 68011 2024-10-18 Glucocorticoids in preterm human milk d1c6c22f6a863ef2050ed9768566884b 0000-0002-6190-7955 Laura Galante Laura Galante true false 2024-10-18 MEDS Background: Glucocorticoids (GCs), cortisol and cortisone, are essential regulators of many physiological responses, including immunity, stress and mammary gland function. GCs are present in human milk (HM), but whether maternal and infant factors are associated with HM GC concentration following preterm birth is unclear.Materials and methods: HM samples were collected on postnatal day 5 and 10 and at 4 months’ corrected age (4m CA) in a cohort of moderate- and late-preterm infants. GCs in HM were measured by liquid chromatography-tandem mass spectrometry. Relationships between GCs in HM and both maternal and infant characteristics were investigated using Spearman’s correlations and linear mixed models.Results: 170 mothers of 191 infants provided 354 HM samples. Cortisol concentrations in HM increased from postnatal day 5–4m CA (mean difference [MD] 0.6 ± 0.1 ng/ml, p < 0.001). Cortisone concentration did not change across lactation but was higher than cortisol throughout. Compared to no antenatal corticosteroid (ANS), a complete course of ANS was associated with lower GC concentrations in HM through to 4m CA (cortisol: MD –0.3 ± 0.1 ng/ml, p < 0.01; cortisone MD –1.8 ± 0.4 ng/ml, p < 0.001). At 4m CA, higher maternal perceived stress was negatively associated with GC concentrations in HM (cortisol adjusted beta-coefficient [aβ] –0.01 ± 0.01 ng/ml, p = 0.05; and cortisone aβ –0.1 ± 0.03 ng/ml, p = 0.01), whereas higher postpartum depression and maternal obesity were associated with lower cortisone concentrations (aβ –0.1 ± 0.04 ng/ml p < 0.05; MD [healthy versus obese] –0.1 ± 0.04 ng/ml p < 0.05, respectively). There was a weak positive correlation between GC concentrations in HM and gestational age at birth (r = 0.1, p < 0.05). Infant birth head circumference z-score was negatively associated with cortisol concentrations (aβ –0.01 ± 0.04 ng/ml, p < 0.05). At hospital discharge, fat-free mass showed a weak positive correlation with cortisol concentrations (r = 0.2, p = 0.03), while fat mass showed a weak negative correlation with cortisone concentrations (r = –0.25, p < 0.001).Conclusion: The mammary gland appears to protect the infant from cortisol through inactivation into cortisone. Maternal and infant characteristics were associated with concentration of GCs in HM, including ANS, stress and depression scores, obesity, gestational age and infant size. The effects of HM glucocorticoids on long-term health outcomes requires further research. Journal Article Frontiers in Nutrition 9 965654 Frontiers Media SA 2296-861X cortisol, cortisone, breastmilk, lactation, nutrition, antenatal corticosteroids, moderate preterm, late preterm 27 9 2022 2022-09-27 10.3389/fnut.2022.965654 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee The DIAMOND trial was funded by the Health Research Council of New Zealand (16/605) and Counties Manukau Health (269). 2025-02-12T14:17:53.2778047 2024-10-18T08:55:48.6756986 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Public Health Mariana Muelbert 1 Tanith Alexander 2 Mark H. Vickers 3 Jane E. Harding 4 Laura Galante 0000-0002-6190-7955 5 Frank H. Bloomfield 6 (for the DIAMOND study group) 7 68011__33198__d85753e332524943a7cdddf0c6051c0a.pdf 68011.VoR.pdf 2024-12-20T11:36:25.1327349 Output 4163553 application/pdf Version of Record true © 2022 Muelbert, Alexander, Vickers, Harding, Galante and Bloomfield. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/
title	Glucocorticoids in preterm human milk
spellingShingle	Glucocorticoids in preterm human milk Laura Galante
title_short	Glucocorticoids in preterm human milk
title_full	Glucocorticoids in preterm human milk
title_fullStr	Glucocorticoids in preterm human milk
title_full_unstemmed	Glucocorticoids in preterm human milk
title_sort	Glucocorticoids in preterm human milk
author_id_str_mv	d1c6c22f6a863ef2050ed9768566884b
author_id_fullname_str_mv	d1c6c22f6a863ef2050ed9768566884b_***_Laura Galante
author	Laura Galante
author2	Mariana Muelbert Tanith Alexander Mark H. Vickers Jane E. Harding Laura Galante Frank H. Bloomfield (for the DIAMOND study group)
format	Journal article
container_title	Frontiers in Nutrition
container_volume	9
container_start_page	965654
publishDate	2022
institution	Swansea University
issn	2296-861X
doi_str_mv	10.3389/fnut.2022.965654
publisher	Frontiers Media SA
college_str	Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
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hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	School of Health and Social Care - Public Health{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Public Health
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description	Background: Glucocorticoids (GCs), cortisol and cortisone, are essential regulators of many physiological responses, including immunity, stress and mammary gland function. GCs are present in human milk (HM), but whether maternal and infant factors are associated with HM GC concentration following preterm birth is unclear.Materials and methods: HM samples were collected on postnatal day 5 and 10 and at 4 months’ corrected age (4m CA) in a cohort of moderate- and late-preterm infants. GCs in HM were measured by liquid chromatography-tandem mass spectrometry. Relationships between GCs in HM and both maternal and infant characteristics were investigated using Spearman’s correlations and linear mixed models.Results: 170 mothers of 191 infants provided 354 HM samples. Cortisol concentrations in HM increased from postnatal day 5–4m CA (mean difference [MD] 0.6 ± 0.1 ng/ml, p < 0.001). Cortisone concentration did not change across lactation but was higher than cortisol throughout. Compared to no antenatal corticosteroid (ANS), a complete course of ANS was associated with lower GC concentrations in HM through to 4m CA (cortisol: MD –0.3 ± 0.1 ng/ml, p < 0.01; cortisone MD –1.8 ± 0.4 ng/ml, p < 0.001). At 4m CA, higher maternal perceived stress was negatively associated with GC concentrations in HM (cortisol adjusted beta-coefficient [aβ] –0.01 ± 0.01 ng/ml, p = 0.05; and cortisone aβ –0.1 ± 0.03 ng/ml, p = 0.01), whereas higher postpartum depression and maternal obesity were associated with lower cortisone concentrations (aβ –0.1 ± 0.04 ng/ml p < 0.05; MD [healthy versus obese] –0.1 ± 0.04 ng/ml p < 0.05, respectively). There was a weak positive correlation between GC concentrations in HM and gestational age at birth (r = 0.1, p < 0.05). Infant birth head circumference z-score was negatively associated with cortisol concentrations (aβ –0.01 ± 0.04 ng/ml, p < 0.05). At hospital discharge, fat-free mass showed a weak positive correlation with cortisol concentrations (r = 0.2, p = 0.03), while fat mass showed a weak negative correlation with cortisone concentrations (r = –0.25, p < 0.001).Conclusion: The mammary gland appears to protect the infant from cortisol through inactivation into cortisone. Maternal and infant characteristics were associated with concentration of GCs in HM, including ANS, stress and depression scores, obesity, gestational age and infant size. The effects of HM glucocorticoids on long-term health outcomes requires further research.
published_date	2022-09-27T05:24:19Z
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score	11.444473

Glucocorticoids in preterm human milk

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