Associations of Maternal Weight Status Before, During, and After Pregnancy with Inflammatory Markers in Breast Milk

Kara M Whitaker, Regina C Marino, Jacob L Haapala, Laurie Foster, Katy D Smith, April M Teague, David R Jacobs, Patricia L Fontaine, Patricia M McGovern, Tonya C Schoenfuss, Lisa Harnack, David A Fields, Ellen W Demerath, Kara M Whitaker, Regina C Marino, Jacob L Haapala, Laurie Foster, Katy D Smith, April M Teague, David R Jacobs, Patricia L Fontaine, Patricia M McGovern, Tonya C Schoenfuss, Lisa Harnack, David A Fields, Ellen W Demerath

Abstract

Objective: The goal of this study was to examine the associations of maternal weight status before, during, and after pregnancy with breast milk C-reactive protein (CRP) and interleukin 6 (IL-6), two bioactive markers of inflammation, measured at 1 and 3 months post partum.

Methods: Participants were 134 exclusively breastfeeding mother-infant dyads taking part in the Mothers and Infants Linked for Health (MILK) study, who provided breast milk samples. Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) were assessed by chart abstraction; postpartum weight loss was measured at the 1- and 3-month study visits. Linear regression was used to examine the associations of maternal weight status with repeated measures of breast milk CRP and IL-6 at 1 and 3 months, after adjustment for potential confounders.

Results: Pre-pregnancy BMI and excessive GWG, but not total GWG or postpartum weight loss, were independently associated with breast milk CRP after adjustment (β = 0.49, P < 0.001 and β = 0.51, P = 0.011, respectively). No associations were observed for IL-6.

Conclusions: High pre-pregnancy BMI and excessive GWG are associated with elevated levels of breast milk CRP. The consequences of infants receiving varying concentrations of breast milk inflammatory markers are unknown; however, it is speculated that there are implications for the intergenerational transmission of disease risk.

Conflict of interest statement

Disclosures:

No other conflicts of interest were reported.

© 2017 The Obesity Society.

Figures

Figure 1. Adjusted means of back-transformed C-reactive…
Figure 1. Adjusted means of back-transformed C-reactive Protein (CRP) at one and three months postpartum by pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) category
Differences between the mean values for each pre-pregnancy BMI and GWG categories are denoted by different superscript letters (a, b, or c). In the top panel, at one month postpartum, normal weight women who gained weight below/within the guidelines (a) had significantly lower breast milk CRP than all other groups (b). Normal weight women who exceeded GWG guidelines also had significantly lower CRP than women with obesity (c), regardless of gestational weight gain category. In the bottom panel, at three months postpartum, normal weight women who gained weight below/within guidelines (a) had significantly lower CRP than all other groups (b). Women with obesity who experienced excessive weight gain (c) had significantly higher CRP than all other groups (p

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