Welcome to the ESPGHAN 2023 Interactive Programme
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ESGE Session - 
EFFECTS OF MEDITERRANEAN DIET ON PREVENTION OF SMALL-FOR-GESTATIONAL AGE BIRTH WEIGHTS IN NEWBORNS (ID 1584)
DIET IN PREGNANCY AND OUTCOMES IN THE OFFSPRING – WHAT HAVE WE LEARNED FROM THE UPBEAT TRIAL? (ID 1586)
N-O026 - MATERNAL SMOKING DURING PREGNANCY HAS A NEGATIVE IMPACT ON NEONATAL CARDIAC FUNCTIONS (ID 1337)
Abstract
Objectives and Study
We hypothesized that maternal smoking in pregnancy could lead to some functional cardiac abnormalities in the infants even in the absence of an evident structural cardiac abnormality, by means of hypoxia and circulatory impairment. In order to detect the potential subclinic effect of maternal smoking during pregnancy, we evaluated the cardiac functions of the otherwise healthy term neonates born to those smoking mothers by the conventional and tissue Doppler echocardiographic studies.
Methods
A prospective, observational study was performed with the apparently healthy term neonates who were categorized in 2 goups : Group 1, infants of smoking mothers, Group 2, infants of non-smoking mothers. The cardiac functions of the infants were evaluated using conventional echocardiography and tissue Doppler echocardiography by a single pediatric cardiologist in a blinded fashion. The functional markers included the myocardial performance index (MPI), tricuspid annular plane systolic excursion (TAPSE), and the systolic and diastolic functional indices of the right and left ventricles in the tissue Doppler imaging.
Results
Out of 62 eligible term infants, 4 infants were excluded due to the structural cardiac anomalies. Fifty-eight newborns completed the study (30 in Group 1, 28 in Group 2). Compared to Group 2, the mean values of right Tri E Vel, right Tri A Vel, right Tri S Vel, right ET, TAPSE, left Mit A Vel, and left ET were significantly lower; whereas, the mean values of RV MPI-TEI and LV MPI-TEI were significantly higher in Group 1; showing that cardiac functions were negatively affected. Group 2 infants were further divided into 2 subgroups based on the presence of maternal household tobacco exposure. Also in the exposure group, neonatal cardiac functions were negatively affected.
Conclusions
To our knowledge this is the first study showing the negative impact of the tobacco on tha cardiac functions of the infants born to the smoking mothers during pregnacy.
EARLY LIFE, GROWTH AND ADIPOSITY: RESULTS FROM THE GENERATION R COHORT (ID 1588)
LONG LASTING EFFECTS OF UNDERNUTRITION IN CRITICAL PERIODS (ID 1590)
N-O009 - MATERNAL IMMUNIZATION DURING THE SECOND TRIMESTER OF PREGNANCY INDUCES A ROBUST IGA RESPONSE IN HUMAN MILK (ID 113)
Abstract
Objectives and Study
Antibody response in human milk (HM) following maternal immunization with BNT162b2 mRNA vaccine is important for neonate protection during early infancy. We aimed to evaluate the antibody response of IgG/IgA/IgM at different lactation stages and to determine the optimal vaccination timing during pregnancy.
Methods
This is a prospective cohort study conducted in Israel between April 2021 and July 2022. We recruited women post-partum who received the BNT162b2 COVID-19 mRNA-vaccine during the second or the third trimester of pregnancy. HM samples, colostrum (day 0-3), transitional milk (4-14 days), mature milk (above 14 days) were collected post-delivery.
Results
Sixty-two lactating women were included. Late colostrum showed the highest median (IQR) antibody concentration of vaccine-specific IgG (1.098 μg/mL [0.489-2.424], IgA (46.19 μg/mL, [30.89-77.54] and IgM (0.144 μg/mL, [0.089-0.356]). Timing of maternal immunization affected the antibody response in transition and mature milk. IgA concentrations were the highest of all isotypes in women immunized during the second trimester versus the third trimester in transitional and mature milk (median [IQR], 13.8 μg/mL [10.32-22.3] vs 9.915 μg/mL [6.199-11.82], P = .01 and 13.06 μg/mL [8.232-18.41] vs 8.51 μg/mL [5.125-12.6], P = .006 respectively). IgG levels were higher when immunization occurred during the third trimester versus second trimester in transitional and mature milk (median [IQR] 0.66 μg/mL [0.538-1.167] vs 0.188 μg/mL [0.128-0.261] and 0.451 μg/mL [0.215-0.704] vs 0.125 μg/mL [0.094-0.208], P < .001, respectively).
Conclusions
Our results suggest that maternal immunization with the BNT162b2 mRNA-vaccine during the second trimester of pregnancy provides a higher concentration of vaccine-specific IgA throughout lactation stages.