在孟加拉国农村地区，孕期的微量营养素状况与儿童的免疫状况相关。

Micronutrient status during pregnancy is associated with child immune status in rural Bangladesh.

作者信息

Jung Da Kyung, Tan Sophia T, Hemlock Caitlin, Mertens Andrew N, Stewart Christine P, Rahman Md Ziaur, Ali Shahjahan, Raqib Rubhana, Grembi Jessica A, Karim Mohammed Rabiul, Shahriar Sunny, Roy Anjan Kumar, Abdelrahman Sarah, Shoab Abul K, Famida Syeda L, Hossen Md Saheen, Mutsuddi Palash, Akther Salma, Rahman Mahbubur, Unicomb Leanne, Hester Lisa, Granger Douglas A, Erhardt Juergen, Naved Ruchira Tabassum, Al Mamun Md Mahfuz, Parvin Kausar, Colford John M, Fernald Lia C H, Luby Stephen P, Dhabhar Firdaus S, Lin Audrie

机构信息

Division of Epidemiology and Biostatistics, School of Public Health, University of California Berkeley, Berkeley, CA, United States.

Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, United States.

出版信息

Curr Dev Nutr. 2023 Jul 4;7(8):101969. doi: 10.1016/j.cdnut.2023.101969. eCollection 2023 Aug.

DOI:10.1016/j.cdnut.2023.101969

PMID:37560460

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10407622/

Abstract

BACKGROUND

Poor immune function increases children's risk of infection and mortality. Several maternal factors during pregnancy may affect infant immune function during the postnatal period.

OBJECTIVES

We aimed to evaluate whether maternal micronutrients, stress, estriol, and immune status during the first or second trimester of pregnancy were associated with child immune status in the first two years after birth.

METHODS

We conducted observational analyses within the water, sanitation, and hygiene (WASH) Benefits Bangladesh randomized controlled trial. We measured biomarkers in 575 pregnant women and postnatally in their children. Maternal biomarkers measured during the first and second trimester of pregnancy included nutrition status via vitamin D (25-hydroxy-D [25(OH)D]), ferritin, soluble transferrin receptor (sTfR), and retinol-binding protein (RBP); cortisol; estriol. Immune markers were assessed in pregnant women at enrollment and their children at ages 14 and 28 mo, including C-reactive protein (CRP), alpha-1-acid glycoprotein (AGP), and 13 cytokines (including IFN-γ). We generated a standardized sum score of log-transformed cytokines. We analyzed IFN-γ individually because it is a critical immunoregulatory cytokine. All outcomes were prespecified. We used generalized additive models and reported the mean difference and 95% confidence intervals at the 25th and 75th percentiles of exposure distribution.

RESULTS

At child age 14 mo, concentrations of maternal RBP were inversely associated with the cytokine sum score in children (-0.34 adjusted difference between the 25th and 75th percentile [95% confidence interval -0.61, -0.07]), and maternal vitamin A deficiency was positively associated with the cytokine sum score in children (1.02 [0.13, 1.91]). At child age of 28 mo, maternal RBP was positively associated with IFN-γ in children (0.07 [0.01, 0.14]), whereas maternal vitamin A deficiency was negatively associated with child AGP (-0.07 [-0.13, -0.02]). Maternal iron deficiency was associated with higher AGP concentrations in children at age 14 mo (0.13 [0.04, 0.23]), and maternal sTfR concentrations were positively associated with child CRP concentrations at age 28 mo (0.18 [0, 0.36]).

CONCLUSION

Maternal deficiencies in vitamin A or iron during the first 2 trimesters of pregnancy may shape the trajectory of a child's immune status.

摘要

背景

免疫功能低下会增加儿童感染风险和死亡率。孕期的几个母体因素可能会影响婴儿出生后的免疫功能。

目的

我们旨在评估孕期头三个月或第二个三个月的母体微量营养素、应激、雌三醇和免疫状态是否与出生后两年内儿童的免疫状态相关。

方法

我们在孟加拉国水、环境卫生和个人卫生（WASH）效益随机对照试验中进行了观察性分析。我们测量了575名孕妇及其子女出生后的生物标志物。孕期头三个月和第二个三个月测量的母体生物标志物包括通过维生素D（25-羟基-D [25(OH)D]）、铁蛋白、可溶性转铁蛋白受体（sTfR）和视黄醇结合蛋白（RBP）评估的营养状况；皮质醇；雌三醇。在入组时对孕妇及其14个月和28个月大的子女进行免疫标志物评估，包括C反应蛋白（CRP）、α-1-酸性糖蛋白（AGP）和13种细胞因子（包括IFN-γ）。我们生成了对数转换后的细胞因子标准化总分。我们单独分析IFN-γ，因为它是一种关键的免疫调节细胞因子。所有结果均预先设定。我们使用广义相加模型，并报告暴露分布第25和第75百分位数处的平均差异和95%置信区间。

结果

在儿童14个月大时，母体RBP浓度与儿童细胞因子总分呈负相关（第2５和第75百分位数之间的调整差异为-0.34 [95%置信区间-0.61，-0.07]），而母体维生素A缺乏与儿童细胞因子总分呈正相关（1.02 [0.13，1.91]）。在儿童28个月大时，母体RBP与儿童IFN-γ呈正相关（0.07 [0.01，0.14]），而母体维生素A缺乏与儿童AGP呈负相关（-0.07 [-0.13，-0.02]）。母体缺铁与14个月大儿童的AGP浓度较高相关（0.13 [0.04，0.23]），母体sTfR浓度与28个月大儿童的CRP浓度呈正相关（0.18 [0，0.36]）。