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Published on: February 15, 2018
Maternal breast milk transforming growth factor-beta and feeding intolerance in preterm infants
Brandy L Frost1, Tamas Jilling2, Brittany Lapin3
11] Department of Pediatrics, NorthShore University HealthSystem, Evanston, Illinois [2] University of Chicago Pritzker School of Medicine, Chicago, Illinois.
Background:
Feeding intolerance (FI) occurs commonly in the neonatal intensive care unit. Breast milk contains a large pool of transforming growth factor-beta (TGF-β). Few studies describe TGF-β levels in preterm milk, and the relationship to FI remains unexplored. We measured TGF-β levels in preterm breast milk to investigate a correlation with FI in preterm infants.
Methods:
Prospective observational trial of 100 mother-infant pairs, enrolling infants born below 32 wk gestation and less than 1,500 g, and mothers who planned to provide breast milk. TGF-β levels were measured using enzyme-linked immunosorbent assay. Infant charts were reviewed for outcomes.
Results:
TGF-β declined postnatally, most elevated in colostrum (P < 0.01). TGF-β2 levels were higher than TGF-β1 at all time points (P < 0.01). Colostrum TGF-β levels correlated inversely with birth weight (P < 0.01) and gestational age (P < 0.05). One-week TGF-β2 levels were reduced in growth-restricted infants with FI (P < 0.01). Of infants with necrotizing enterocolitis (NEC), TGF-β2 levels appeared to be low, but small sample size precluded meaningful statistical comparisons.
Conclusion:
TGF-β levels decline temporally in preterm milk. TGF-β1 colostrum levels correlate inversely with birth weight and gestational age. TGF-β2 may play a role in FI in growth-restricted infants. The relationship of TGF-β2 and NEC merits future investigation.
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