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Prenatal Antibiotics and Breast Milk / Neonatal IgA

Recruiting
Conditions
Prenatal Exposure Delayed Effects
Dysbiosis
Antibiotic Prophylaxis
Neonatal Infection
Breast Milk; Noxious Influence, Affecting Fetus
Interventions
Drug: Antibiotics
Registration Number
NCT05813184
Lead Sponsor
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
Brief Summary

In this biological study, the investigators will evaluate the levels of breast milk IgA, neonatal fecal IgA, and the composition of breast milk and fecal microbiota throughout the first 12 months of life in neonates born to mothers treated or not treated with prenatal antibiotics for at least 7 days after the 32nd weeks of gestation

Detailed Description

In a human cohort of women and their neonates, the investigators aim to evaluate the absolute amount of IgA in maternal breast milk and in neonatal feces in the presence (N=41 mother/infant pairs) or in the absence (N=41 mother/infant pairs) of exposure to prenatal ABX during the last period of pregnancy. Moreover, the investigators aim to evaluate, both in maternal breast milk and in neonatal feces, the composition of microbiota, and the proportion and composition of the IgA-coated and not-IgA- coated fractions of microbiota, by means of fluorescence-activated cell sorting (FACS) coupled with 16S rRNA sequencing of bacteria. Finally, the investigators will measure the concentration of the chemokine CCL28 on maternal serum and breast milk, as a soluble marker of activity of the entero-mammary pathway that is known to drive the migration of IgA producing plasma- cells from maternal mesenteric lymph nodes to the mammary gland.

All the analysis will be performed in mother-infant dyads with exclusive breastfeeding. Breast milk/serum/feces collection and analysis will be repeated at the following timepoints:

1. during the first week of neonatal life

2. at 1 month of life

3. at 3 months of life

4. at 8-12 months of life (or at the time of breastfeeding interruption), after the introduction of solid food in the infant's diet.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
82
Inclusion Criteria
  • expression of written informed consent
  • an antibiotic treatment (any molecule) for at least 7 days consecutively after the 32 weeks of pregnancy (or the absence of exposure to any systemic antibiotic treatment during pregnancy for the control group)
  • the intention to breastfeed their neonates as long as possible during the first year of life
Exclusion Criteria
  • absence of written informed consent
  • the intention to formula feed exclusively (or the presence of significant maternal concerns about breastfeeding)
  • a maternal antibiotic treatment shorter than 7 days
  • the presence of pre-existing maternal immune-mediated disorders (including immunodeficiencies and chronic infectious diseases)
  • a delivery at a gestational age < 34 weeks
  • the administration of antibiotics to neonates after birth, within the first week of life.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Prenatal antibioticsAntibioticsWomen exposed to antibiotics for at least 7 days from the 32nd week of gestation
Primary Outcome Measures
NameTimeMethod
breast milk IgAuntil 12 months of neonatal life

concentration of IgA in breast milk

Secondary Outcome Measures
NameTimeMethod
fecal IgAuntil 12 months of neonatal life

concentration of IgA in neonatal feces

breast milk microbiotauntil 12 months of neonatal life

Composition of microbiota in breast milk and analysis of fractions coated or uncoated by IgA

fecal microbiotauntil 12 months of neonatal life

Composition of microbiota in breast milk and analysis of fractions coated or uncoated by IgA

maternal CCL28until 12 months of neonatal life

concentration of CCL28 in maternal serum and breast milk

Trial Locations

Locations (1)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

🇮🇹

Milan, Italy

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