Title

Effects of anticipated neonatal surgical intervention on maternal milk cytokine production.

Document Type

Article

Publication Date

1-1-2017

Identifier

DOI: 10.1016/j.jpedsurg.2016.10.017

Abstract

BACKGROUND: Maternal stress on neonatal outcomes of infants admitted to the NICU is incompletely understood. We previously demonstrated breast milk derived cytokines remain biologically active in the neonatal intestine. We hypothesized that the need for neonatal surgical intervention would be stimulus leading to maternal cytokine production thus affecting neonatal outcome.

METHODS: Discarded expressed breast milk (EBM) in the first 3weeks following delivery was analyzed for IL-23 and IL-10 by ELISA. Variables analyzed included: the need for a pediatric surgical procedure, the need for cardiac surgical procedure, no surgical interventions, and survival. All values are expressed as mean±SEM. Statistical analysis utilized Kruskal and Mann-Whitney test.

RESULTS: EBM from mothers whose infants required any surgical procedure (n=19) revealed significant elevation in IL-10 but not IL-23 compared to nonsurgical EBM (n=18). Subdivided by procedure type, there was no difference between those undergoing a cardiac (n=9) versus pediatric surgical (n=10) procedure in both IL-10 and IL-23. Mothers whose infants requiring surgical intervention or whose infants did not survive in the first 3weeks of life had elevation of IL-10.

CONCLUSION: Results suggest maternal stress impacts the cytokine profile of breast milk.

LEVEL OF EVIDENCE: Level III.

Journal Title

Journal of pediatric surgery

Volume

52

Issue

1

First Page

45

Last Page

49

MeSH Keywords

Anticipation, Psychological; Female; Humans; Infant, Newborn; Interleukin-10; Interleukin-23; Milk, Human; Mothers; Stress, Psychological; Surgical Procedures, Operative

Keywords

Cardiac surgery; Cytokine; Il-10; Il-23; Inflammation; Necrotizing enterocolitis; CHD; NEC

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