Fundação Oswaldo Cruz, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Rio de Janeiro, RJ, Brazil.
Rev Paul Pediatr. 2023 Nov 24;42:e2023001. doi: 10.1590/1984-0462/2024/42/2023001. eCollection 2023.
The objective of this study was to evaluate the influence of maternal and perinatal factors on the nutritional composition of human milk.
A cross-sectional study was conducted between November 2018 and January 2020, with 181 donors selected in Tertiary Health Units of the Unified Health System - from one collection station and five Human Milk Banks. Data were collected through a standardized questionnaire. To be fit to be a donor in a Human Milk Banks and produce mature milk were the eligibility criteria to participate in the study. We excluded milk samples with Dornic acidity above 8° D. The dependent variables were the macronutrients of human milk (i.e., carbohydrates, proteins, lipids, and total energy), that were analyzed using spectroscopy with the Miris Human Milk Analyzer™. The maternal and perinatal factors were the independent variables.
Women with pre-gestational obesity and gestational weight gain above the recommendation showed a lower protein concentration compared to eutrophic women (median=0.8, interquartile range (IQR): 0.7-0.9 vs. median=0.8, and IQR: 0.8-1.0) and those with adequate gestational weight gain (median=0.8, IQR: 0.7-0.9 vs. median=0.9, and IQR: 0.8-1.0), respectively. The other analyzed factors (i.e., maternal habits, comorbidities, and perinatal factors) were not associated with the nutritional composition of human milk.
The assessment of factors associated with the nutritional composition of human milk is extremely important to assist postpartum care. Pre-gestational obesity and inadequate gestational weight gain were the only factors statistically associated with the nutritional composition of human milk as they impacted its protein content.
本研究旨在评估母婴及围产期因素对人乳营养成分的影响。
这是一项横断面研究，于 2018 年 11 月至 2020 年 1 月在统一卫生系统的三级卫生单位进行，共从一个采集站和五个人乳库中选择了 181 名捐赠者。通过标准化问卷收集数据。成为人乳库捐赠者并产生成熟乳是参与研究的入选标准。我们排除了酸度超过 8°D 的牛奶样本。人乳的宏量营养素（即碳水化合物、蛋白质、脂肪和总能量）是依赖变量，使用 Miris Human Milk Analyzer™ 进行光谱分析。母婴及围产期因素是独立变量。
与营养良好的女性相比，孕前肥胖和体重增加超过推荐量的孕妇其蛋白质浓度较低（中位数=0.8，四分位距（IQR）：0.7-0.9 与中位数=0.8，IQR：0.8-1.0），且与体重增加充足的孕妇相比（中位数=0.8，IQR：0.7-0.9 与中位数=0.9，IQR：0.8-1.0）。其他分析因素（即产妇习惯、合并症和围产期因素）与人乳的营养成分无关。
评估与人乳营养成分相关的因素对于产后护理非常重要。孕前肥胖和体重增加不足是唯一与人乳营养成分统计学相关的因素，因为它们影响了人乳的蛋白质含量。
