ESPE Abstracts

Introduction: Accumulating evidence indicates various but significant effects of human milk IGF1 (HMIGF1) on infantile and childhood linear growth and weight gain. Studies on maternal factors affecting the level of HMIGF1 need to be clarified.

Objectives and Methods: We performed electronic literature systematic review using PubMed, Google Scholar, and Web of Sciences with the aim to provide an update on maternal factors that may affect postnatal HMIGF1 level.

Results: We reviewed 12 studies (n= 745 women) fitting the search criteria.  In a cohort study (n=501) HM IGF-1 concentrations displayed a positive correlation with maternal weight gain during pregnancy, which was maintained when correcting for maternal pre-pregnancy weight. In a prospective, longitudinal, observational cohort study, (n= 58) the levels of HM IGF-1 was higher in women with excess (> 32%) versus those with adequate (≤ 32%) total body fat. The IGF-1 / cyclic Glycine-Proline ratio (cGP) ratio displayed a positive correlation with gestational age (β = 0.103, P = 0.033). C-section was associated with lower HM IGF-1 vs those delivered vaginally. Moderate increases in HM IGF-1 concentrations occurred from early lactation to 4 months corrected age. IGF-1/cGP ratio showed a sex-specific interaction with maternal basic education (P = 0.035). Higher IGF1 in maternal serum had a significant association with its HMIGF1. Post-feed HMIGF-1 levels of mothers with obesity were correlated with infant's weight for length z-score at 2 months (r -0•476; P= 0•034). In a controlled study (60 patients with gestational diabetes (GDM), and 96 normal women, and their newborn babies), GDM did not significantly affect the concentrations of IGF-1, -2, IGFBP-3 in the peripheral blood and umbilical cord blood but decreased markedly maternal and fetal IGFBP-2 concentrations. Another study reported higher levels of HMIGF-1 in milk of diabetic mothers and the blood serum of their babies. (n=30) and found a significant correlation between their HMIGF-1 levels and all the anthropometric measurements of their infants. A significant association was reported between GDM and HMIGF1-1: cGP ratio (P = 0.035).

Conclusion: These data provide evidence that maternal factors (weight gain during pregnancy, obesity, gestational diabetes, preterm labor, and C-section) can affect the concentration of HMIGF1.