Human Milk Melatonin Across Early Lactation in Preterm Birth: Maternal, Pregnancy, and Neonatal Correlates.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Breastfeeding Medicine Pub Date : 2026-10-07 DOI:10.1177/15568253261494547

Nicolina Anagnostatou, Elena Vakonaki, Eleftherios Panteris, Zacharenia Golemi, Thomas Lamprakis, Antonios Makrigiannakis, Manolis N Tzatzarakis, Eleftheria Hatzidaki

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引用次数: 0

Abstract

Background: Melatonin is a multipotent neuroendocrine transducer. Human-milk melatonin is the sole source of exogenous melatonin in the neonatal period, this being especially true for premature infants. This study aimed to examine maternal, pregnancy, and neonatal correlates of human-milk melatonin concentrations measured at three predefined lactational stages-colostrum, transitional, and mature milk-in mothers of preterm infants, as well as the variation of melatonin concentration in human milk during the first postnatal month, possibly shedding light on an understudied area of neonatal nutrition.

Methods: This longitudinal observational cohort enrolled 101 mothers who delivered 128 infants before 35 completed weeks of gestation. Melatonin was quantified by ELISA in daytime milk samples obtained at T1 (postnatal days 2-5), T2 (days 10-14), and T3 (days 20-28).

Results: Human-milk melatonin declined across early lactation, with significantly lower concentrations in mature milk than in colostrum (T3 versus T1: geometric mean ratio [GMR]: 0.74, 95% confidence interval [CI]: 0.62-0.88, p < 0.001). Fetal growth restriction (FGR) was associated with lower melatonin concentrations after adjustment for the predefined maternal and pregnancy covariates (GMR: 0.76, 95% CI: 0.58-1.00, p = 0.046). No significant correlation was found with any of the other maternal, obstetric, or neonatal demographic characteristics.

Conclusions: This longitudinal study indicates that daytime human-milk melatonin decreases from colostrum to mature milk during the first postnatal month in mothers of preterm infants. Among the maternal, pregnancy, and neonatal factors examined, FGR was the only factor independently associated with lower milk melatonin concentrations. These findings support the need for larger longitudinal studies combining maternal, placental, and milk melatonin measurements in order to clarify the biological basis of this association and its possible clinical relevance for infants born preterm.

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母乳褪黑素在早产早期哺乳中的作用：母体、妊娠和新生儿相关。

背景：褪黑素是一种多能神经内分泌换能器。人乳褪黑素是新生儿期外源性褪黑素的唯一来源，对早产儿尤其如此。本研究旨在研究早产儿母亲在三个预先确定的哺乳期（初乳、过渡期和成熟乳）测量的母乳中褪黑激素浓度与母体、妊娠和新生儿的相关性，以及产后第一个月母乳中褪黑激素浓度的变化，可能会对新生儿营养研究不足的领域有所帮助。方法：这一纵向观察队列纳入了101名母亲，她们在妊娠35周前分娩了128名婴儿。在T1（出生后2-5天）、T2（10-14天）和T3（20-28天）获得的日间牛奶样品中，用ELISA法定量褪黑素。结果：人乳褪黑激素在哺乳期早期下降，成熟乳中的褪黑激素浓度显著低于初乳（T3与T1：几何平均比[GMR]: 0.74, 95%可信区间[CI]: 0.62-0.88, p < 0.001）。在调整母体和妊娠协变量后，胎儿生长受限（FGR）与较低的褪黑激素浓度相关（GMR: 0.76, 95% CI: 0.58-1.00, p = 0.046）。未发现与任何其他产妇、产科或新生儿人口统计学特征有显著相关性。结论：这项纵向研究表明，早产儿母亲在出生后的第一个月，从初乳到成熟乳，白天人乳褪黑素减少。在母亲、怀孕和新生儿因素中，FGR是唯一与牛奶褪黑激素浓度降低独立相关的因素。这些发现支持了对母体、胎盘和乳汁褪黑素测量进行更大规模纵向研究的必要性，以阐明这种关联的生物学基础及其与早产婴儿可能的临床相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS

CiteScore

4.20

自引率

11.10%

发文量

130

审稿时长

6-12 weeks

期刊介绍： Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.