Gestational Diabetes Mellitus and Colostral Appetite-Regulating Adipokines.

Gestational diabetes mellitus (GDM) is a complex metabolic disorder that has short- and long-term effects on maternal and offspring health. This study aimed to assess the impact of maternal hyperglycemia severity, classified as GDM-G1 (diet treatment) and GDM-G2 (insulin treatment) on colostral appetite-regulating molecules. Colostrum samples were collected from hyperglycemic (N = 30) and normoglycemic (N = 21) mothers, and the concentrations of milk hormones were determined by immunoenzymatic assay. A difference was found for milk ghrelin, but not for molecules such as adiponectin, leptin, resistin, or IGF-I levels, in relation to maternal hyperglycemia. The colostral ghrelin in the GDM-G1 cohort (0.21 ng/mL) was significantly lower than for GDM-G2 (0.38 ng/mL) and non-GDM groups (0.36 ng/mL). However, colostral resistin was higher, but not significantly, for GDM-G1 (13.33 ng/mL) and GDM-G2 (12.81 ng/mL) cohorts than for normoglycemic mothers (7.89 ng/mL). The lack of difference in relation to hyperglycemia for milk leptin, adiponectin, leptin-adiponectin ratio, resistin, and IGF-I levels might be the outcome of effective treatment of GDM during pregnancy. The shift between ghrelin and other appetite-regulating hormones might translate into altered ability to regulate energy balance, affecting offspring's metabolic homeostasis.

Attitude and Level of COVID-19 Vaccination among Women in Reproductive Age during the Fourth Pandemic Wave: A Cross-Sectional Study in Poland.

COVID-19 vaccination, apart from the sanitary regime, is the most efficient strategy to limit the spread of the SARS-CoV-2 virus and significantly reduce the severity of the disease following infection. A cross-sectional survey was conducted during the fourth wave of the COVID-19 pandemic among pregnant Polish women and women who have already given birth to evaluate the level and attitude to vaccination. Briefly, 1196 women (256 pregnant and 940 mothers) participated in the study; 68.0% of pregnant women and 66.2% of mothers declared that they had received COVID-19 vaccination. The most frequently stated reasons not to get vaccinated were possible adverse effects on the mother, fetus or breastfed child, post-vaccination complications and limited scientific evidence on the safety of the COVID-19 vaccine. The identified predictors of avoiding COVID-19 vaccination are young age, residing in small cities or rural areas, cohabitation, low anxiety level regarding SARS-CoV-2 infection, and little knowledge concerning maternal vaccine-induced immune protection delivered to offspring. Despite the unlimited access to COVID-19 vaccination, the declared level of vaccination is worryingly low. The knowledge concerning the benefits of vaccination to mothers and their offspring is not satisfactory and requires urgent educational action, particularly among young women living outside big cities and single motherhood.

Factors affecting the mother's choice of infant feeding method in Poland: a cross-sectional preliminary study in Poland.

BACKGROUND: The World Health Organization identifies exclusive breastfeeding as the gold standard for child nutrition. Breastfeeding provides many benefits to both the baby and the mother. First days after birth are crucial for breastfeeding and determining its further path. Unfortunately, very often it is also the time of facing the first breastfeeding problems. The aim of this study was to analyse selected factors influencing a mother's decision to breastfeed. METHODS: This is a cross-sectional study conducted between March 2019 and November 2019 in selected Polish maternity wards. Data were collected through completion of author's questionnaire and a standardised questionnaire and the Multidimensional Perceived Social Support Scale and also through informal interviews with mothers. During statistical analysis, the chi-square test of independence and the Kolmogorov-Smirnov test as well as the non-parametric Mann-Whitney U test in addition to Fisher's exact test were performed. RESULTS: The results showed that there is no correlation between the mode of delivery and the mother's choice of infant feeding method. Knowledge of the benefits of breastfeeding and received support affects the mother's decision on infant feeding method. The study also showed that the 83% of newborns were put to the breast within the first 2 h after birth. However, only 58% continued to be breastfed in the subsequent days. As many as 42% of the newborns were supplemented with formula despite early initiation of breastfeeding. Analyses showed that exclusive breastfeeding was more often chosen by mothers with higher education. And the most common breastfeeding problem reported by 62% of the respondents was perceived insufficient milk supply and also breastfeeding pain, reported in 48.5% mothers. CONCLUSIONS: It is extremely important to continually promote breastfeeding among women. The role of midwives is crucial in this regard, as they should encourage the initiation of breastfeeding, support mothers during the perinatal and postnatal periods, and increase their sense of competence and confidence in their ability to breastfeed. Accessible, professional, and empathetic support can help reduce the number of women supplementing with modified milk. Undoubtedly, the postpartum period is important for breastfeeding outcomes, but it is significant that breastfeeding education and promotion begin during pregnancy.

Lactoferrin and Immunoglobulin Concentrations in Milk of Gestational Diabetic Mothers.

Gestational diabetes mellitus (GDM) is associated with an increased risk of having a high-care newborn and has an impact on maternal wellbeing. This study aimed to assess the effect of GDM on the lactoferrin (LF), secretory immunoglobulin A (SIgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) concentrations in early colostrum, colostrum, and transitional milk samples of hyperglycemic (n = 53) and normoglycemic (n = 49) mothers using enzyme-linked immunosorbent assay (ELISA). The concentrations of milk lactoferrin and SIgA, but not IgG and IgM, from hyperglycemic and normoglycemic mothers, showed a similar negative correlation with lactation from the first to the fifteenth day. Apart from early colostral IgG, there were no differences in concentrations of LF and immunoglobulins in milk from hyperglycemic and normoglycemic mothers. For hyperglycemia compensated by diet (GDM G1) or insulin treatment (GDM G2), slight differences were seen for LF and IgG, but not for SIgA and IgM, during an early stage of lactation only. Early colostral IgG and colostral LF of insulin-treated mothers were higher (10.01 ± 4.48 mg/L and 11.50 ± 0.58 g/L, respectively) than for diet-control diabetic mothers (7.65 ± 5.67 mg/L and 8.05 ± 1.38 g/L, respectively). GDM of mothers does not have a significant impact on immunological quality of early milk.

Echocardiographic ultrasound screening assessment of the circulatory system of newborns delivered at basic level perinatal care centers.

BACKGROUND: For many years standards of medical care for newborns have been created and perfected with the goal of improving care, including early detection of congenital defects. OBJECTIVES: The objective of the study was to assess the circulatory system in newborns born at basic level of perinatal care centers and the comparison of specific parameters of cardiac function and structure according to the method of birth, body mass, sex, Apgar score, pulse oximetry results, and presence of other pathologies. MATERIAL AND METHODS: The study was carried out in 255 newborns aged 3-14 days. The children were assessed according to Apgar score, were weighed and pulse oximetry testing was carried out, and symptoms of neonatal jaundice or infection were taken into account. Each child was subjected to a physical examination and echocardiographic examination. RESULTS: Among the group studied, 3.5% of children had defects of the circulatory system and functional disorders. CONCLUSIONS: Pulse oximetry testing, due to its low level of invasiveness, high sensitivity and specificity, low cost and repeatability, should be used as the primary screening test, allowing for early detection of critical congenital heart defects (CHDs). It should be stressed that the test should be repeated before discharge of newborns from the neonatology department so as to avoid missing CHDs which are asymptomatic or mute at birth. Morphological and functional assessment of specific structures of the heart in delivered newborns showed correlation of the size of the left ventricle (LV) with body mass. The remaining factors, such as method of delivery, sex, neonatal jaundice, and audible murmur, were irrelevant. Routine cardiological assessment of healthy newborns is therefore not necessary.

Lectin-Based Method for Deciphering Human Milk IgG Sialylation.

In light of the immunoprotective function of human milk and the incontestable impact of IgG glycosylation on its immune functions, characterization of the sialylation profile of human milk IgG is needed. Lectins as a molecular probe were applied in lectin-IgG-ELISA to analyze the sialylation and galactosylation pattern of skim milk IgG of mothers who delivered at term and prematurely. Well-defined biotinylated lectins were used: Maackia amurensis II (MAA II), Sambucus nigra (SNA), Ricinus communis I (RCA I), and Griffonia simplicifolia II (GSL II) specific to α2,3-Neu5Ac, α2,6-Neu5Ac, Gal(ß1,4)GlcNAc, and agalactosylated glycans, respectively. The sialylation pattern of milk IgG differs qualitatively and quantitatively from maternal plasma IgG and is related to lactation stage and perinatal risk factors. Expression of MAA-, SNA-, and GSL-reactive glycotopes on term milk IgG showed a positive correlation with milk maturation from days 1 to 55. Preterm birth was associated with an increase of MAA-reactive and a decrease of RCA-reactive IgG glycotopes. Moreover, higher SNA- and GSL-reactive and lower RCA-reactive glycoform levels of milk IgG were associated with infection of lactating mothers. Application of a specific and simple method, lectin-IgG-ELISA, reveals the sialylation pattern of milk IgG over milk maturation. However, further investigations are needed in this area.

Delivery-associated presence of supramolecular fibronectin-fibrin complexes in puerperal and cord plasma.

Objective: The variable fibronectin (FN) molecular forms are known to be engaged in coagulation and fibrinolysis pathways as well as tissue remodeling and repair processes. Some of them seem to be indispensable molecules within intensive biological processes associated with delivery. The aim of the study was to evaluate the FN molecular status in maternal and cord plasma after vaginal birth and cesarean section (C-section). Materials and methods: The study included nonpregnant women's plasma samples (n = 31) and puerperal and cord plasma samples collected from 49 mothers who delivered healthy newborns at term by vaginal birth (n = 25) and C-section (n = 24). The maternal and cord plasma FN concentrations and presence and relative ratios of different FN-fibrin complexes were determined by ELISA and sodium dodecyl sulfate (SDS) -agarose immunoblotting, respectively. Results: FN concentration in puerperal plasma after vaginal birth (232.08 ± 71.8 mg/L) and C-section (228.17 ± 71.2 mg/L) was significantly higher than in the plasma of nonpregnant women (190.00 ± 48.75 mg/L). In contrast, FN concentration in cord plasma of the C-section group (101.95 ± 30.3 mg/L) was significantly lower than that of the vaginal birth group (121.80 ± 22.2 mg/L). Immunoblotting of puerperal and cord plasma distinguished the most abundant dimeric plasma FN form, the 220-280-kDa FN degradation products and 750-1900-kDa FN-fibrin complexes, which occurred more frequently and in higher amounts in puerperal and cord plasma groups than the nonpregnant women group, although independently of the mode of delivery. Conclusions: Occurrence and relative amount of delivery-associated FN-fibrin complexes in both puerperal and cord plasmas might be bound with the physiological adaptive mechanisms reducing the risk of hemorrhage and intensive remodeling and repair processes after delivery.

Lectin-based analysis of fucosylated glycoproteins of human skim milk during 47 days of lactation.

Glycoproteins of human milk are multifunctional molecules, and their fucosylated variants are potentially active molecules in immunological events ensuring breastfed infants optimal development and protection against infection diseases. The expression of fucosylated glycotopes may correspond to milk maturation stages. The relative amounts of fucosylated glycotopes of human skim milk glycoproteins over the course of lactation from the 2(nd) day to the 47(th) day were analyzed in colostrums, transitional and mature milk samples of 43 healthy mothers by lectin-blotting using α1-2-, α1-6-, and α1-3-fucose specific biotinylated Ulex europaeus (UEA), Lens culinaris (LCA), and Lotus tetragonolobus (LTA) lectins, respectively. The reactivities of UEA and LCA with the milk glycoproteins showed the highest expression of α1-2- and α1-6-fucosylated glycotopes on colostrum glycoproteins. The level of UEA-reactive glycoproteins from the beginning of lactation to the 14(th) day was high and relatively stable in contrast to LCA-reactive glycoproteins, the level of which significantly decreased from 2-3 to 7-8 days then remained almost unchanged until the 12(th)-14(th) days. Next, during the progression of lactation the reactivities with both lectins declined significantly. Eighty percent of α1-2- and/or α1-6-fucosylated glycoproteins showed a high negative correlation with milk maturation. In contrast, most of the analyzed milk glycoproteins were not recognized or weakly recognized by LTA and remained at a low unchanged level over lactation. Only a 30-kDa milk glycoprotein was evidently LTA-reactive, showing a negative correlation with milk maturation. The gradual decline of high expression of α1-2- and α1-6-, but not α1-3-, fucoses on human milk glycoproteins of healthy mothers over lactation was associated with milk maturation.

O-glycosylation of α-1-acid glycoprotein of human milk is lactation stage related.

BACKGROUND: Human milk provides a multitude of glycoproteins, including highly glycosylated α-1-acid glycoprotein (AGP), which elicits anti-inflammatory and immunomodulatory properties. The milk AGP glycoforms may provide the breastfed infant with a wide range of biological benefits. Here, we analyzed the reactivity of O-linked sugar-specific lectins with human milk AGP over the process of lactation and compared the results with those of the lactating mother's plasma. MATERIALS AND METHODS: Relative amounts of human skim milk AGP O-glycans were analyzed in early colostrum, colostrum, and transitional and mature milk samples of 127 healthy mothers by lectin-AGP enzyme-linked immunosorbent assay using sialyl T (sialyl-α2,3/α2,6 Galß1,3GalNAc-), asialyl T (Galß1,3GalNAc-), and Tn (GalNAc-) antigen-specific biotinylated Artocarpus integrifolia (Jacalin), Arachis hypogaea (PNA), and Vicia villosa (VVA) lectins, respectively. RESULTS: Milk AGP elicited high expression of Jacalin- and PNA-reactive glycotopes and low expression of VVA-reactive glycotopes, which were absent on plasma AGP of lactating mothers and healthy individuals. The expression of sialyl, asialyl T, and Tn glycotopes of human milk AGP was lactation stage related. The relative amount of Jacalin-reactive AGP glycotope was highest in the colostrum samples and then decreased starting from Day 8 of lactation. In contrast, an increase of the relative amount of PNA-reactive glycotope with milk maturation was observed. The relative amount of VVA-reactive glycotope remained almost constant over the development of lactation. CONCLUSIONS: Milk AGP differs from mother's plasma AGP by the presence of O-linked sialylated and asialylated T as well as Tn antigens. The variation of the expression of sialylated and asialylated T and Tn antigens on AGP is associated with milk maturation.

Terminal glycotope expression on milk fibronectin differs from plasma fibronectin and changes over lactation.

OBJECTIVES: Fibronectin (FN) is a multifunctional glycoprotein appearing in various glycovariants with potential biological activities. Using lectins we analyzed the expression of terminal glycotopes on human milk fibronectin over lactation and compared it with that of the mother's plasma. DESIGN AND METHODS: FN concentration and relative amounts of its fucosylated and sialylated glycovariants as well as O-glycans were analyzed in early colostrum, colostrum, transitional and mature milk samples of 132 healthy mothers by lectin-FN-ELISA using α2,3- and α2,6-sialic acid, α1,2-, α1,3-, and α1,6-fucose, and sialyl-T, asialyl-T and Tn antigen specific biotinylated Maackia amurensis, Sambucus nigra, Ulex europaeus, Tetragonolobus purpureus, Lens culinaris, Artocarpus integrifolia, Arachis hypogaea, and Vicia villosa lectins, respectively. RESULTS: FN concentration was almost unchanged during human milk maturation and was about 150 times lower than in plasma of lactating mothers. Milk FN elicited significantly higher expression of sialylated glycotopes including sialyl-T antigen than plasma FN, and contained fucose-linked glycans, as well as T and Tn antigens absent in plasma FN. With milk maturation the expression of α2,6-sialylated, sialyl-T, α1,6- and α1,2-fucosylated epitopes decreased in transitional milk compared with colostrum, whereas that of asialyl-T antigen increased. The expression levels of α2,3-sialyl- and α1,3-fucosyl-glycotopes and Tn antigen on FN were low and did not change over lactation. CONCLUSION: The expression of terminal sugars on milk FN is different from that of plasma FN of the lactating mother and is associated with milk maturation. The analysis of degree of milk sialylation and fucosylation should be considered during control of biochemical quality of milk collected in milk banks.

Lactation stage-related expression of sialylated and fucosylated glycotopes of human milk α-1-acid glycoprotein.

BACKGROUND: Because terminal sugars of α-1-acid glycoprotein (AGP) are reported to be involved in anti-inflammatory and immunomodulatory processes, their expressions might have an influence on the proper function of immune system of newborns. Here, relative amounts of sialylated and fucosylated glycotopes on human milk AGP over normal lactation were investigated. MATERIALS AND METHODS: AGP concentration and relative amounts of its sialylated and fucosylated glycovariants were analyzed in early colostrum, colostrum, and transitional and mature milk samples of 127 healthy mothers by lectin-AGP enzyme-linked immunosorbent assay using α2,3- and α2,6-sialic acid and α1,2-, α1,3-, and α1,6-fucose specific biotinylated Maackia amurensis, Sambucus nigra, Ulex europaeus, Tetragonolobus purpureus, and Lens culinaris lectins, respectively. RESULTS: AGP concentration in human milk was about 30 times lower than in plasma of lactating mothers and decreased gradually over lactation. Milk AGP showed significantly higher expression of sialylated and fucosylated glycotopes in comparison with those of plasma AGP. Milk AGP glycovariants containing α2,6-sialylated and α1,6- and α1,2-fucosylated glycotopes showed the highest relative amounts in early colostrums. With progression of lactation, the expressions of glycotopes α1,2-fucosylated decreased starting from Day 4 and those of α2,6-sialylated and α1,6-fucosylated from Day 8 of lactation, whereas the level of α2,3-sialyl-glycotope was almost constant over 45 days of lactation. In contrast, the expression of α1,3-linked fucose on AGP was low in colostrums and significantly higher in transitional and mature milk. CONCLUSIONS: The relative amounts of sialylated and fucosylated glycovariants of human hindmilk AGP significantly varied between Days 2 and 45 of normal lactation.