Maternal serum amino acids and hydroxylated sphingomyelins at pregnancy are associated with anxiety symptoms during pregnancy and throughout the first year after delivery.

BACKGROUND: Studies suggest an interplay between maternal metabolome and mental health. OBJECTIVE: We investigated the association of maternal serum metabolome at pregnancy with anxiety scores during pregnancy and throughout the first year postpartum. METHODS: A prospective cohort of Brazilian women collected 119 serum metabolome at pregnancy (28-38 weeks) and anxiety scores measured by the State-Trait Anxiety Inventory (STAI) at pregnancy (n = 118), 1 (n = 83), 6 (n = 68), and 12 (n = 57) months postpartum. Targeted metabolomics quantified metabolites belonging to amino acids (AA), biogenic amines/amino acid-related compounds, acylcarnitines, lysophosphatidylcholines, diacyl phosphatidylcholines, alkyl:acyl phosphatidylcholines, non-hydroxylated and hydroxylated sphingomyelins [SM(OH)], and hexoses classes. Linear mixed-effect models were used to evaluate the association of metabolites and STAI scores. Hierarchical clustering and principal component analyses were employed to identify clusters and metabolites, which drove their main differences. Multiple comparison-adjusted p-values (q-value) ≤ 0.05 were considered significant. RESULTS: AA (ß = -1.44) and SM(OH) (ß = -1.49) classes showed an association with STAI scores trajectory (q-value = 0.047). Two clusters were identified based on these classes. Women in cluster 2 had decreased AA and SM(OH) concentrations and higher STAI scores (worse symptoms) trajectory (ß = 2.28; p-value = 0.041). Isoleucine, leucine, valine, SM(OH) 22:1, 22:2, and 24:1 drove the main differences between the clusters. LIMITATIONS: The target semiquantitative metabolome analysis and small sample size limited our conclusions. CONCLUSIONS: Our results suggest that AA and SM(OH) during pregnancy play a role in anxiety symptoms throughout the first year postpartum.

Association between persistent organic pollutants in human milk and the infant growth and development throughout the first year postpartum in a cohort from Rio de Janeiro, Brazil.

Persistent organic pollutants (POPs) are compounds that are recalcitrant and ubiquitous that bioaccumulate in human milk (HM) and can impact infant growth and development. We explore the association between POP concentration in HM at 2-50 days postpartum and infant growth and development trajectory throughout the first year of life. A cohort of 68 healthy adult Brazilian women and their infants were followed from 28 to 35 gestational weeks to 12 months postpartum. HM samples were collected between 2 and 50 days postpartum, and POP concentrations were analyzed using gas chromatography with mass spectrometry. Concentrations of POPs >limit of quantification (LOQ) were defined as presence, and concentrations ≤LOQ as an absence. Growth z-scores were analyzed according to WHO growth charts and infant development scores according to Age & Stages Questionnaires at 1 (n = 66), 6 (n = 50), and 12 months (n = 45). Linear mixed effects (LME) models were used to investigate the association of POPs in HM with infant growth and development. Benjamini-Hochberg (BH) correction for multiple testing was performed to reduce the false discovery ratio. P < 0.1 was considered for models with the interaction between POPs and time/sex. After BH correction, adjusted LME models with time interaction showed (1) a positive association between the presence of ß hexachlorocyclohexane and an increase in head circumference-for-age z-score (ß = 0.003, P = 0.095); (2) negative associations between total POPs (ß = -0.000002, P = 0.10), total organochlorine pesticides (ß = -0.000002, P = 0.10), and dichlorodiphenyldichloroethylene concentrations in HM (ß = -0.000002, P = 0.10) and fine motor scores. No statistical difference between the sexes was observed. Postnatal exposure to organochlorine pesticides in HM shows a positive association with the trajectory of head circumference-for-age z-score and a negative association with the trajectories of fine motor skills scores. Future studies on POP variation in HM at different postpartum times and their effect on infant growth and development should be encouraged.

Prepregnancy Body Mass Index and Lipoprotein Fractions are Associated with Changes in Women's Serum Metabolome from Late Pregnancy to the First Months of Postpartum.

BACKGROUND: Pregnancy and postpartum are periods of intense changes in women's metabolism. The knowledge of the metabolites and maternal factors underlying these changes is limited. OBJECTIVES: We aimed to investigate the maternal factors that could influence serum metabolome changes from late pregnancy to the first months of postpartum. METHODS: Sixty-eight healthy women from a Brazilian prospective cohort were included. Maternal blood and general characteristics were collected during pregnancy (28-35 wk) and postpartum (27-45 d). A targeted metabolomics approach was applied to quantify 132 serum metabolites, including amino acids, biogenic amines, acylcarnitines, lysophosphatidylcholines (LPC), diacyl phosphatidylcholines (PC), alkyl:acyl phosphatidylcholines (PC-O), sphingomyelins with (SM) and without hydroxylation [SM(OH)], and hexoses. Metabolome changes from pregnancy to postpartum were measured as log2 fold change (log2FC), and simple linear regressions were employed to evaluate associations between maternal variables and metabolite log2FC. Multiple comparison-adjusted P values of < 0.05 were considered significant. RESULTS: Of 132 metabolites quantified in serum, 90 changed from pregnancy to postpartum. Most metabolites belonging to PC and PC-O classes decreased, whereas most LPC, acylcarnitines, biogenic amines, and a few amino acids increased in postpartum. Maternal prepregnancy body mass index (ppBMI) showed positive associations with leucine and proline. A clear opposite change pattern was observed for most metabolites across ppBMI categories. Few phosphatidylcholines were decreased in women with normal ppBMI, while an increase was observed in women with obesity. Similarly, women with high postpartum levels of total cholesterol, LDL cholesterol, and non-HDL cholesterol showed increased sphingomyelins, whereas a decrease was observed for women with lower levels of those lipoproteins. CONCLUSIONS: The results revealed several maternal serum metabolomic changes from pregnancy to postpartum, and the maternal ppBMI and plasma lipoproteins were associated with these changes. We highlight the importance of the nutritional care of women prepregnancy to improve their metabolic risk profile.

Association of pre-pregnancy maternal overweight/obesity and dietary intake during pregnancy with the concentrations of persistent organic pollutants in the human milk of women from Rio de Janeiro, Brazil.

Persistent organic pollutants (POPs) are toxic chemical compounds that can bioaccumulate, adhere to lipid matrices, and affect human health. This study aimed to investigate the association between maternal pre-pregnancy overweight/obesity and dietary intake during pregnancy and POP concentrations in the human milk of women from Rio de Janeiro, Brazil. One hundred and forty-seven women were followed from the third trimester of pregnancy until 119 days postpartum, and 77 human milk samples were analyzed between 2 and 119 days postpartum. POP concentrations were analyzed using gas chromatography-triple quadrupole mass spectrometry. Pregnancy dietary intake was estimated using a semi-quantitative food frequency questionnaire, and pre-pregnancy body mass index at baseline was classified as normal or overweight/obesity. Multiple logistic and linear regression models were performed to investigate the association between pre-pregnancy overweight/obesity, dietary intake during pregnancy, and POP concentrations in human milk. The models were adjusted for maternal age, maternal schooling, total cholesterol serum concentrations, and time postpartum. The analyses were corrected for multiple comparisons using the Benjamini-Hochberg test. Significant associations were observed between pre-pregnancy overweight/obesity and dichlorodiphenyldichloroethane (ppDDE), polychlorinated biphenyl (PCB)74, PCB138, PCB153, PCB170, PCB180, total PCBs, total 4PCBs, total 2 organochlorine pesticides (OCPs), and total POP concentrations. Higher daily lipid intake during pregnancy increased human milk hexachlorobenzene (HCB). This study showed that pre-pregnancy overweight/obesity and total lipid intake during pregnancy were associated with POP concentrations in the milk of women from Rio de Janeiro, Brazil. To promote adequate nutritional status since preconception and surveillance and control of POP in the environment could be essential to ensure binomial mother-infant health and biomonitoring studies and programs for these POPs should be stimulated.

Maternal Mental Health in Late Pregnancy and Longitudinal Changes in Postpartum Serum Vitamin B-12, Homocysteine, and Milk B-12 Concentration Among Brazilian Women.

Background: Little is known regarding the association between mental health distress during pregnancy and postpartum maternal serum biomarkers of vitamin B-12 status and milk B-12 concentration. Objective: To evaluate the association between depressive and anxiety symptoms in the third trimester of pregnancy and changes in postpartum serum B-12, homocysteine, and B-12 milk concentration. Methods: A total of 101 women (18-40 years) were studied in a prospective cohort with data at the third trimester of pregnancy (baseline) and three postpartum time-points (TPs): 2-8 days (TP1), 28-50 days (TP2), and 88-119 days (TP3) postpartum. B-12 concentrations in milk were measured by competitive chemiluminescent enzyme immunoassay at TP1, TP2, and TP3. Serum B-12 and homocysteine concentrations were evaluated at baseline, TP1, TP2, and TP3 by chemiluminescent immunoassays. Depressive and anxiety symptoms were measured with the Edinburgh Postnatal Depression Scale and the State-Trait Anxiety Inventory at baseline. Spearman's correlation test and multiple linear mixed-effect models were performed. Results: The prevalence of depressive and anxiety state symptoms was 35.6 and 39.6% at baseline. High prevalence of low milk B-12 concentration (<310 pmol/L) were observed at TP1 (53.2%), TP2 (71.4%), and TP3 (71.1%). Women with anxiety symptoms at baseline presented higher median concentrations of serum homocysteine at TP1 and lower concentrations of serum and milk B-12 at TP2 compared with women without anxiety symptoms [8 (7; 9) vs. 6 (5; 8) and 266 (188; 369) vs. 332 (272; 413)]. Milk B-12 concentrations were positively and significantly correlated with maternal serum B-12 concentrations at different TP. Women with anxiety symptoms at baseline exhibited a decrease in daily postpartum homocysteine concentrations compared to women without anxiety symptoms (ß = -0.002, SE = 0.001, p = 0.024). Conclusion: Anxiety symptoms at the end of pregnancy were associated with longitudinal changes in maternal serum homocysteine concentrations during the first 3 months postpartum.

Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis.

The purpose of this study was to evaluate the effects of resistance training alone on the systolic and diastolic blood pressure in prehypertensive and hypertensive individuals. Our meta-analysis, followed the guidelines of PRISMA. The search for articles was realized by November 2016 using the following electronic databases: BIREME, PubMed, Cochrane Library, LILACS and SciELO and a search strategy that included the combination of titles of medical affairs and terms of free text to the key concepts: 'hypertension' 'hypertensive', 'prehypertensive', 'resistance training', 'strength training', and 'weight-lifting'. These terms were combined with a search strategy to identify randomized controlled trials (RCTs) and identified a total of 1608 articles: 644 articles BIREME, 53 SciELO, 722 PubMed, 122 Cochrane Library and 67 LILACS. Of these, five RCTs met the inclusion criteria and provided data on 201 individuals. The results showed significant reductions for systolic blood pressure (-8.2 mm Hg CI -10.9 to -5.5;I2: 22.5% P valor for heterogeneity=0.271 and effect size=-0.97) and diastolic blood pressure (-4.1 mm Hg CI -6.3 to -1.9; I2: 46.5% P valor for heterogeneity=0.113 and effect size=-0.60) when compared to group control. In conclusion, resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive subjects. The RCTs studies that investigated the effects of resistance training alone in prehypertensive and hypertensive patients support the recommendation of resistance training as a tool for management of systemic hypertension.