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Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda
BACKGROUND: Adverse birth outcomes, including preterm birth and stunting at birth, have long-term health implications. The relation between adverse birth outcomes and chronic, asymptomatic gastrointestinal inflammation (environmental enteric dysfunction—EED) is poorly understood. OBJECTIVE: We aimed...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186209/ https://www.ncbi.nlm.nih.gov/pubmed/30247538 http://dx.doi.org/10.1093/ajcn/nqy176 |
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author | Lauer, Jacqueline M Duggan, Christopher P Ausman, Lynne M Griffiths, Jeffrey K Webb, Patrick Agaba, Edgar Nshakira, Nathan Tran, Hao Q Gewirtz, Andrew T Ghosh, Shibani |
author_facet | Lauer, Jacqueline M Duggan, Christopher P Ausman, Lynne M Griffiths, Jeffrey K Webb, Patrick Agaba, Edgar Nshakira, Nathan Tran, Hao Q Gewirtz, Andrew T Ghosh, Shibani |
author_sort | Lauer, Jacqueline M |
collection | PubMed |
description | BACKGROUND: Adverse birth outcomes, including preterm birth and stunting at birth, have long-term health implications. The relation between adverse birth outcomes and chronic, asymptomatic gastrointestinal inflammation (environmental enteric dysfunction—EED) is poorly understood. OBJECTIVE: We aimed to examine the relation between maternal EED and adverse birth outcomes in a sample of pregnant Ugandan women and their newborn infants. DESIGN: We conducted a prospective cohort study in Mukono, Uganda. A total of 258 pregnant women were enrolled at their first prenatal visit (∼18 weeks of gestation). EED was measured by urinary lactulose:mannitol (L:M) ratio and serum concentrations of antibodies to the bacterial components flagellin and LPS. Covariates were obtained from survey data collected at 2 time points. Associations were assessed through the use of unadjusted and adjusted simple linear regression models. RESULTS: Complete birth outcome data were recorded for 220 infants within 48 h of delivery. Mean ± SD gestational age was 39.7 ± 2.1 wk, and 7% were born preterm. Mean ± SD length and length-for-age z score (LAZ) at birth were 48.1 ± 3.2 cm and −0.44 ± 1.07, respectively. L:M ratio was not associated with any birth outcome. In adjusted models, higher concentrations of natural log-transformed anti-flagellin immunoglobin G (IgG) and anti-LPS IgG were significantly associated with shorter length of gestation (β: −0.89 wk; 95% CI: −1.77, −0.01 wk, and β: −1.01 wk; 95% CI: −1.87, −0.17 wk, respectively) and with reduced length (β: −0.80 cm; 95% CI: −1.55, −0.05 cm, and β: −0.79 cm; 95% CI: −1.54, −0.04 cm, respectively) and LAZ at birth (β −0.44 z score; 95% CI: −0.83, −0.05, and β: −0.40 z score; 95% CI: −0.79, −0.01, respectively). CONCLUSION: Maternal anti-flagellin and anti-LPS IgG concentrations in pregnancy, but not L:M ratio, were associated with shorter gestation and reduced infant length at birth. Further research on the relation between maternal EED and birth outcomes is warranted. |
format | Online Article Text |
id | pubmed-6186209 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-61862092018-10-18 Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda Lauer, Jacqueline M Duggan, Christopher P Ausman, Lynne M Griffiths, Jeffrey K Webb, Patrick Agaba, Edgar Nshakira, Nathan Tran, Hao Q Gewirtz, Andrew T Ghosh, Shibani Am J Clin Nutr Original Research Communications BACKGROUND: Adverse birth outcomes, including preterm birth and stunting at birth, have long-term health implications. The relation between adverse birth outcomes and chronic, asymptomatic gastrointestinal inflammation (environmental enteric dysfunction—EED) is poorly understood. OBJECTIVE: We aimed to examine the relation between maternal EED and adverse birth outcomes in a sample of pregnant Ugandan women and their newborn infants. DESIGN: We conducted a prospective cohort study in Mukono, Uganda. A total of 258 pregnant women were enrolled at their first prenatal visit (∼18 weeks of gestation). EED was measured by urinary lactulose:mannitol (L:M) ratio and serum concentrations of antibodies to the bacterial components flagellin and LPS. Covariates were obtained from survey data collected at 2 time points. Associations were assessed through the use of unadjusted and adjusted simple linear regression models. RESULTS: Complete birth outcome data were recorded for 220 infants within 48 h of delivery. Mean ± SD gestational age was 39.7 ± 2.1 wk, and 7% were born preterm. Mean ± SD length and length-for-age z score (LAZ) at birth were 48.1 ± 3.2 cm and −0.44 ± 1.07, respectively. L:M ratio was not associated with any birth outcome. In adjusted models, higher concentrations of natural log-transformed anti-flagellin immunoglobin G (IgG) and anti-LPS IgG were significantly associated with shorter length of gestation (β: −0.89 wk; 95% CI: −1.77, −0.01 wk, and β: −1.01 wk; 95% CI: −1.87, −0.17 wk, respectively) and with reduced length (β: −0.80 cm; 95% CI: −1.55, −0.05 cm, and β: −0.79 cm; 95% CI: −1.54, −0.04 cm, respectively) and LAZ at birth (β −0.44 z score; 95% CI: −0.83, −0.05, and β: −0.40 z score; 95% CI: −0.79, −0.01, respectively). CONCLUSION: Maternal anti-flagellin and anti-LPS IgG concentrations in pregnancy, but not L:M ratio, were associated with shorter gestation and reduced infant length at birth. Further research on the relation between maternal EED and birth outcomes is warranted. Oxford University Press 2018-10 2018-09-22 /pmc/articles/PMC6186209/ /pubmed/30247538 http://dx.doi.org/10.1093/ajcn/nqy176 Text en © 2018 American Society for Nutrition. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Research Communications Lauer, Jacqueline M Duggan, Christopher P Ausman, Lynne M Griffiths, Jeffrey K Webb, Patrick Agaba, Edgar Nshakira, Nathan Tran, Hao Q Gewirtz, Andrew T Ghosh, Shibani Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title | Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title_full | Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title_fullStr | Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title_full_unstemmed | Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title_short | Biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in Uganda |
title_sort | biomarkers of maternal environmental enteric dysfunction are associated with shorter gestation and reduced length in newborn infants in uganda |
topic | Original Research Communications |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6186209/ https://www.ncbi.nlm.nih.gov/pubmed/30247538 http://dx.doi.org/10.1093/ajcn/nqy176 |
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