发酵乳干预对超重肥胖孕产妇母乳成分和母子健康的影响

Effects of Fermented Dairy on Human Milk Components of Overweight or Obese Pregnant Woman and Maternal-child Health

生命早期1000 d是影响人生健康的重要窗口期,饮食是影响母婴健康的重要因素。采用随机对照的方式将超重或肥胖人群随机分为发酵乳组和对照组,发酵乳组自孕早期干预到产后6个月,每日摄入富含益生菌益生元的酸奶200 mL。产后定期采集母乳,收集母婴健康随访表、爱丁堡产后抑郁量表(EPDS),探究发酵乳干预对母乳微生物和宏量成分、母亲身体质量指数(BMI)、婴儿体重、产后抑郁、婴幼儿神经心理发育的影响。研究结果表明:相较于对照组,发酵乳干预显著降低产后42 d韦荣氏球菌属、痤疮丙酸杆菌属、链球菌属、罗斯氏菌属、奈瑟氏菌属等菌属的相对丰度,显著提高罗尔斯通菌属的相对丰度;大肠志贺氏杆菌、罕见小球菌属的相对丰度在产后3~6个月显著上升,链球菌属的相对丰度显著降低。另外,发酵乳干预显著增加产后3~6个月母乳中富含α-乳白蛋白、乳铁蛋白、溶菌酶等多种功能蛋白的真蛋白含量,对产后1~5 d,42 d,3~6个月内母亲身体质量指数、婴儿体重以及产后42 d的产妇产后抑郁、婴幼儿神经心理发育无显著作用。临床研究证明:通过富含益生菌、益生元发酵乳干预产妇,可以显著调节母乳微生物的结构,显著增加真蛋白含量,具有潜在的改善婴幼儿健康的作用。

The first 1000 days is a critical window of opportunity to promote healthy life,during which diet is an important factor.The study used randomized clinical trial to randomly divide the overweight or obese pregnant women into fermented dairy group intervened with fermented dairy from early pregnancy to six months postpartum and control group.Members in fermented dairy group were arranged 200 mL yogurt containing probiotics and prebiotics everyday.Fresh human milk samples,follow-up table for maternal-child health,and Edinburgh Postnatal Depression Scale(EPDS)were collected regularly postpartum to investigate the effect of fermented dairy on microbiota and macronutrients of human milk,mothers'body mass index(BMI)and postpartum depression,weight and neuropsychological development of infants.The results showed that compared with control group,fermented dairy intervention would significantly reduce the relative abundance of Veillonella,Cutibacterium,Streptococcus,Rothia,Neisseria and other microbiomes and improve the relative abundance of Ralstonia in human milk of 42 d postpartum.For human milk of 3-6 month postpartum,the relative abundance of Escherichia-Shigella,Subdoligranulum increased significantly and the relative of Streptococcus decreased significantly in the fermented dairy group compared with the control group.Besides,fermented dairy intervention improved significantly the content of true protein that contained functional proteins such asα-lactalbumin,lactoferrin and lysozyme in human milk of 3-6 months postpartum.There were no differences in other outcomes including mothers'body mass index,infants'weight and neuropsychological development.In conclusion,fermented dairy riched in probiotics and prebiotics could significantly regulate human milk's microbiota and true protein content,which might be helpful for infants'health.