Mohamad, Marhazlina
(2016)
The role of maternal serum and breast milk adipokines in determining postpartum and infant adiposity development.
Masters thesis, Universiti Sains Malaysia.
Abstract
Obesity has been a great concern in Malaysia since there is an alarming increase in
its prevalence. Besides storing fat, adipose tissue is also an endocrine organ that secretes a
large number of adipokines. Pregnancy, a state with metabolic changes, has been recognized
as a critical period for the development of maternal and infant adiposity as a result of
imbalanced adipokines production. Hence, the Universiti Sains Malaysia Pregnancy Cohort
Study was established to investigate the role of maternal serum and breast milk adipokines
(adiponectin and leptin) in determining the first year postpartum weight retention (PPWR)
and infant adiposity development. This study was conducted from April 2010 until
December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited
at first and second trimester of pregnancy in Kelantan, Malaysia. Data collection were
consisted of maternal socio-demography, medical history, anthropometry, dietary, physical
activity, physical discomforts and clinical biochemistry analysis; and infant’s anthropometry
and feeding patterns. Fasting serum samples were taken during pregnancy for the serum
glucose, lipid profile, adiponectin and leptin levels analyses. Breast milk samples were
collected at birth and 2 months postpartum. Data collection was performed at second and
third trimester of pregnancy, continued with follow-up visits at birth, 2 months, 6 months
and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to
examine; 1) the associations of maternal serum adiponectin with breast milk adiponectin
within 2 months postpartum; 2) the associations of prenatal factors and maternal serum
adiponectin and leptin on 12 months PPWR; and 3) the associations of maternal serum and
breast milk adiponectin and leptin on infant adiposity development. MLR models showed
that breast milk adiponectin at birth increased with increasing maternal serum adiponectin atthird trimester (p=0.006), while breast milk adiponectin at 2 months postpartum increased
with increasing maternal serum adiponectin at second and third trimesters respectively
(p=0.035, p=0.006). At 12 months postpartum, PPWR increased with increasing weight gain
rate (WGR) at third trimester (p<0.001), and decreased with increasing HDL-cholesterol at
second trimester (p<0.001). In the first year of age, as maternal serum and breast milk
adiponectin increased, infant weight, BMI-for-age Z-scores, abdominal circumference and
triceps skinfold significantly decreased (p<0.05). In conclusion, 1) maternal serum
adiponectin during pregnancy was associated with breast milk adiponectin within 2 months
postpartum; 2) WGR and HDL-cholesterol during pregnancy were related with 12 months
PPWR; and 3) maternal serum and/or breast milk adiponectin were associated with the first
year infant adiposity development. The favourable results of breast milk adiponectin
indicated the potential role of breastfeeding practice in the prevention of obesity since
infanthood.
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