Low Birthweight Infant, Preterm, Very Low Birth Weight Preterms
Conditions
Keywords
low birth weight, prematurity, gestational age, human milk, bioactive peptides, proteomics, lactation, whey protein
Brief summary
Human milk (HM) is the optimal food source for the nutrition, growth, and development of newborns. The protein fraction of HM plays a crucial role in the healthy development of infants. HM contains a wide variety of minor whey proteins and peptides with important bioactive functions, many of which are still unknown. Proteomics allows for the study of biological samples with inherently complex protein mixtures. Proteins are essential for the development of living organisms, both in quantitative and qualitative terms. The combination of proteomic techniques currently enables the study of protein variability and minor peptides in HM across different lactation stages and allows for differential quantification according to gestational age and birth weight. However, studies on the human milk serum proteome during these stages are limited. The aim is to explore the minor whey proteins and peptides in human milk through a longitudinal analysis of five groups of breastfeeding mothers (with 30 extremely low birth weight newborns, 30 very low birth weight newborns, 30 low birth weight newborns, 30 adequate birth weight newborns, and 30 high birth weight newborns). Gestational age will also be considered to ensure homogeneous group distribution according to this condition. HM samples will be collected from each mother during three lactation periods after birth: within the first 48 hours (colostrum), at 5-14 days (transitional milk), and at 100-120 days (mature milk) for the five birth weight groups. In these neonatal/infant groups, minor proteins from whey fraction and peptides will be separated, quantified, and identified using label-free proteomic techniques. This study aims to expand our understanding of the minor proteins and peptides in human milk and their bioactive roles in neonatal health. By examining these components across different birth weight groups and lactation stages, the research will offer insights into how protein and peptide profiles vary by gestational age and birth weight, potentially influencing neonatal development. The findings from this proteomic analysis could not only demonstrate the complexity of human milk composition but also contribute to targeted nutritional support for preterm or low-birth-weight infants, customizing protein supplementation in HM banks and therefore enhancing their growth and developmental outcomes.
Interventions
None listed
Sponsors
Hospital Universitario Reina Sofia de Cordoba
Universidad de Granada
Universidad de Córdoba
Maimónides Biomedical Research Institute of Córdoba
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Days to 120 Days
Healthy volunteers
Yes
Inclusion criteria
* Healthy mothers * With monitored pregnancies within the care area of the Reina Sofía University Hospital in Córdoba * With newborns expected to be exclusively breastfed until 4 months
Exclusion criteria
* Mothers whose newborns have any of the following conditions: congenital malformation, chromosomal abnormality, hypoxia-ischemia, gastroschisis, polycythemia, hypoglycemia, sepsis, blood incompatibility * Pathological pregnancy, pregnancy by in vitro fertilization, or multiple pregnancies * With no plan to exclusively breastfeed until 4 months * Under medical treatment * Have a drug addiction * Refuse informed consent * Have had previous breast surgery * Live outside the metropolitan area
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Free peptides, primarily derived from β-casein | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Free peptides will be expressed in counts per peptide. Human milk samples will undergo trypsin digestion prior to analysis by liquid chromatography-mass spectrometry (LC-MS). |
| Minor whey proteins: Lactoferrin | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Concentration of lactoferrin in mg/ml will be measured using immunoassays (Enzyme-Linked ImmunoSorbent Assay). |
| Minor whey proteins: Bile salt-dependent lipase (BSDL) | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Concentration of bile salt-dependent lipase (BSDL) in µg/ml will be measured using immunoassays (Enzyme-Linked ImmunoSorbent Assay). |
| Minor whey proteins: Lactoperoxidase | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Concentration of lactoperoxidase in ng/ml will be measured using immunoassays (Enzyme-Linked ImmunoSorbent Assay). |
| Minor whey proteins: Alpha-1-antitrypsin | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Concentration of alpha-1-antitrypsin in ng/ml will be measured using immunoassays (Enzyme-Linked ImmunoSorbent Assay). |
| Proteome | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Protein signatures will be assessed through a proteomic analysis using nano-liquid chromatography (nESI-MS/MS). The analysis will be followed by bioinformatic analysis with dedicated software to analyze and achieve the relative quantification of differential proteins. A specific database representing the human proteome, updated in the UNIPROT repository, will be used. The results will be compared against the protein databases available in international platforms such as SWISS-Prot, NCBI, EBI, and TrEMBL. The results are typically expressed in units or formats that reflect the relative abundance or quantitative values of proteins or peptides, such as spectral counts, percentage and µg/ml. |
| Minor whey proteins: Lysozyme | Human Milk collection after birth - Time 1: at 48 hours (colostrum),Time 2: at 5-14 days (transitional milk), Time 3: at 100-120 days (mature milk) | Concentration of lysozyme in ng/ml will be measured using immunoassays (Enzyme-Linked ImmunoSorbent Assay). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscular ecography | After birth - Time 1: at 48 hours,Time 2: at 5-14 days, Time 3: at 100-120 days | Muscle thickness will be measured using a Phillips HD ultrasound equipment, with a high-frequency linear probe (7.5 MHz - 15 MHz), in B-mode. The thickness (expressed in mm) of the right quadriceps muscle and subcutaneous tissue will be measured, taken at the midpoint between the greater trochanter and tibial plateau: one anteroposterior in longitudinal section, another anteroposterior in transverse plane, and another perpendicular to the latter in the same plane. |
| Transfontanellar ecography | After birth - Time 1: at 48 hours,Time 2: at 5-14 days, Time 3: at 100-120 days | Brain structure and anatomy will be measured using a convex probe with a frequency range of (3.5 - 7 MHz) in B-mode. Longitudinal and transverse sections will be measured, and the thickness of the frontal cortex and the maximum thickness of the corpus callosum will be measured in millimeters (mm). |
Other
| Measure | Time frame | Description |
|---|---|---|
| General information - Newborns | After birth - Time 1: at 48 hours,Time 2: at 5-14 days, Time 3: at 100-120 days (mothers will be asked if any changes have occurred) | A general questionnaire will be completed regarding newborn characteristics, including gestational age, birth weight and length, sex, feeding type, and any pre- and/or postnatal complications or infections. |
| Dietary intake and eating habits | After birth - Time 1: at 48 hours,Time 2: at 5-14 days, Time 3: at 100-120 days | Food Consumption Frequency Questionnaire (CFCA) at the beginning of the study will be conducted, along with a 3-day food diary during the three stages of breastfeeding. |
| General information - Mothers | After birth - Time 1: at 48 hours,Time 2: at 5-14 days, Time 3: at 100-120 days (mothers will be asked if any changes have occurred) | Mothers will complete a general questionnaire to gather information on sociodemographic factors, pregnancy, breastfeeding, medical conditions or complications, medications, and lifestyle habits |
Countries
Spain
Contacts
Primary ContactJosé Luis Gómez-Chaparro Moreno, MD, Ph.D
Backup ContactÁngel Gil, Professor
Outcome results
None listed