Title:Colostrum Antibodies and Cytokines in Puerperal Women with Diabetes
Before and During the COVID-19 Pandemic: A Systematic Review
Volume: 19
Issue: 3
Author(s): Rosane Nassar Meireles Guerra*, Cláudia Regina Silva dos Santos Cunha, Marcela Patrícia Macêdo Belo Fort, Eremita Val Rafael, Rebeca Aranha Arrais e Silva Santos, Mônica Virginia Viegas Lima-Aragão, Mayara Cristina Pinto Silva and Flávia Raquel Fernandes Nascimento
Affiliation:
- Laboratório de Imunofisiologia, Universidade Federal do Maranhão, Avenida dos Portugueses, 1966, Centro São
Luís- MA, Brazil
Keywords:
Breast milk, gestational diabetes, IgA, cytokines, SARS-CoV-2, COVID-19.
Abstract:
Background: Breastfeeding maintains the maternal-fetal immune link after birth, favors
the transmission of immunological competence, and is considered an important contributing factor
to the development of the babies’ immune system.
Objective: This study aimed to obtain data related to the effects of gestational diabetes on immunoglobulin
A (IgA) and cytokines levels in the colostrum, before and during the pandemic of the
new coronavirus, in order to study the possible outcomes regarding the immunological characteristics
of human milk.
Methods: This systematic review was registered in PROSPERO CRD42020212397, and the question
elaborated using the PICO strategy was: does maternal hyperglycemia associated or not with
Covid-19 influence the immunological composition of colostrum? Electronic searching and reference
lists of published reports were used to identify studies that reported the influence of gestational
diabetes on colostrum and milk composition.
Results: Seven studies were selected from the 51 found, six of them were cross-sectional and one
was a case report. Six studies included Brazilian groups and only one was conducted in USA. The
mothers with gestational diabetes presented a reduced level of IgA and other immunoreactive proteins
in colostrum. Those alterations could be related to changes in macronutrient metabolism and
cellular oxidative metabolism.
Conclusion: It was possible to conclude that diabetes changes the immunological composition of
breast milk; however, data on the impact of the association between gestational diabetes and
Covid-19 infection on the composition of antibodies and cytokines present in human milk are still
scarce and inconclusive.