Department of Biochemistry, School of Medicine, University of Nairobi, Nairobi, Kenya.
Department of Pediatric Hematology & Oncology, Joint Clinical Research Centre, Kampala, Uganda.
Breastfeed Med. 2024 Jun;19(6):409-424. doi: 10.1089/bfm.2023.0274. Epub 2024 Apr 5.
Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.
母乳是婴儿营养的金标准，根据需要提供营养和生物活性分子，以支持婴儿最佳生长和认知发育。越来越多的证据将人乳低聚糖 (HMO) 与这些幼儿发展里程碑联系起来。 总结和综合与 HMO 和婴儿大脑发育、身体生长和认知发育相关的证据。此外，通过荟萃分析比较了分泌型和非分泌型母亲的 HMO 浓度。 按照 PRISMA 声明进行了系统评价和荟萃分析。本综述使用了三个数据库（PubMed、Scopus 和 Web of Science），并且仅限于 2000 年至 2023 年 6 月 30 日期间以英文发表的文章。初步搜索产生了 245 篇文章，其中 27 篇被纳入系统评价，12 篇被纳入荟萃分析。荟萃分析显示研究之间存在很大的异质性， = 97.3%。汇总效应为 0.21（95%CI：-0.41 至 0.83； = 0.484），表明分泌型者的 HMO 浓度较高，尽管这一差异无统计学意义。在一个月大时，2'FL、3FL 和 3'SL 在大脑成熟中起重要作用，因此对认知发育起着关键作用。分泌型者产生更高浓度的 2'FL 和 3'SL，这解释了分泌型母亲对婴儿的益处。生长速度与岩藻糖基化和唾液酸化 HMO 浓度相关，浓度较低与发育迟缓有关。 根据系统评价文章的证据，HMO 对儿童早期发育至关重要，但它们的影响程度取决于母亲的分泌状态。
