The Content Of N-3 Polyunsaturated Fatty Acid In The Breast Milk Of Women With Gestational Diabetes Mellitus And Its Effect On The Early Growth And Development Of Infants

ObjectiveTo explore the relationship between the changes of n-3PUFA content in breast milk of GDM parturients and the early development of their infants,we analyzed longitudinally changes of(polyunsaturated fatty acids,n-3PUFA)in breast milk of gestational diabetes mellitus(gestational diabetes mellitus,GDM)parturients and normal parturients within 3 months after delivery respectively,and at the same time the growth indexes(body length,weight,head circumference,adaptability,great exercise,fine exercise,language,personal social development quotient,etc.)in the early stage of birth were monitored.Methods1.Group:from June 2016 to December 2017,100 parturients were recruited in Department of Obstetrics,Huadu District people’s Hospital of Guangzhou.Among them,50 pairs of GDM parturients and their infants were the observation group(GDM group),50 pairs of parturients without pregnancy complications and their infants as the control group.All the participants had a comprehensive understanding of the study and signed informed consent.2.Data collection:general data of the two groups of parturients,including pre-pregnancy height,weight,weight gain during pregnancy,educational level,number of births,etc.3.Breast milk specimens collection:2-3 days after delivery,12-14 days after delivery,1 month after delivery and 3 months after delivery were collected respectively.At the same time,24 hours food review was used to analyze the diet of parturients.4.Routine nutrient analysis of breast milk:The energy,carbohydrate,fat and protein content in breast milk were determined using the Miris HMA breast milk analyzer.5.Determination of n-3PUFA,including aalpha-linolenic acid(α-ALA),eicosapentaenoic acid(EPA)and docosahexaenoic acid(DHA)in breast milk:The contents of EPA,DHA and ALA in colostrum,、transitional milk and mature milk were determined by gas chromatography-mass spectrometry.6.Monitoring growth indexes of infants:1 month and 3 months of age,including body length,weight,head circumference,adaptability,great exercise,fine exercise,language,and personal social development quotient.7.Statistics:SPSS 19.0 was used.Measurement data were expressed byx?s,and t test was used to compare between groups.Counting data were expressed by frequency and rate,and?~2 test was used for comparison between groups.Single factor analysis of n-3PUFA content in maternal milk of GDM and early infant growth and development using Spearman correlation analysis.P<0.05 as the difference was statistically significant.ResultsThe pre-pregnancy and pregnancy weight gain in GDM group were higher than those in control group(P<0.05),but there was no significant difference in other basic data indexes(P>0.05).1st and 3rd month after delivery,the protein intake of parturients in GDM group was higher than that in control group(P<0.05).There was no significant difference in lipid intake between the two groups at four time points,but the carbohydrate intake in control group was higher than that in GDM group(P<0.05).On the 2nd~3rd or 2nd and 14th day after delivery,the energy intake in the control group was higher than that in the GDM group.The fat content and energy of mature milk in GDM group were higher than those in control group at 1 month and 3 months(P<0.05),but there was no significant difference in fat content and energy between colostrum and transitional milk(P>0.05).There was no significant difference in protein and carbohydrate content between the two groups in each time period(P>0.05).The contents of DHA,EPA and ALA in GDM group were lower than those in control group at 4 time points,and the difference was statistically significant(P<0.05).The net increment of body length,body weight and head circumference of the infants in GDM group were lower than those in the control group in the first three months,and there was significant difference between the two groups(P<0.05),and at the age of 1month,there were significant differences in the developmental quotient of adaptability,exercise and personal social interaction between the two groups(P<0.05),the score in the GDM group was significantly lower.At the age of 3 months,the scores of large exercise,fine exercise and language in GDM group were significantly lower than those in control group(P<0.05),and the total developmental quotient GDM group at 1 month and 3 months old was significantly lower than that in control group(P<0.05).The content of DHA in breast milk was positively correlated with the net proliferation of body length,the net increment of body weight,the net increment of head circumference and the total development quotient(P<0.05),and the content of EPA was positively correlated with the net proliferation of infant body weight,the net increment of head circumference and the total developmental quotient(P<0.05).There was a positive correlation between ALA and net body weight gain(P<0.05).ConclusionThe early growth and development index and total development quotient of GDM group were on the low side.Compared with normal parturients,the content ofα-ALA,EPA,DHA in breast milk of gestational diabetes mellitus women in the lower lever,while the content of n-3PUFA in breast milk decreased,which may have a negative effect on the early physical and intellectual growth and development of infants.