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| Name | Class |
|---|---|
| University of the Philippines | OTHER |
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To assess protection against early life infections through supplementation of mothers during pregnancy to the newborns' growth, morbidity, immune status intra and extra-uterine.
During pregnancy mothers have to fulfill the tremendous physiological needs to support their own immune status as well as that of their babies. Accordingly, it appears highly valuable to provide mothers with a nutritional supplement during pregnancy and lactation to promote the immune development in newborns, thus reinforcing the infants' defenses.
In that respect, an appropriate maternal diet must provide sufficient energy and nutrients to meet the mother's usual requirements and promote health status, as well as the needs of the growing fetus and beyond for the neonate.
Key organogenesis steps take place during fetal life and many functional features of the immune system are already coded in the genetic asset of the individual. However, at birth the immune system remains fairly immature. An epigenetic, postnatal instruction seems to be extremely important for the maturation of the immune system allowing its full functionality.
The cross-talk between the mother and her baby is, indeed, crucial for the optimal development of the foetus and subsequently for the full and functional maturation of the neonate.
The newborn relies for his protection almost exclusively on his innate immune system that is initially instructed and educated early in life by factors derived from his mother as well as post-natal environmental factors such as early life colonization with micro-organisms that activates the innate immunity and enhance Th1-cell polarization thereby potentially reducing atopic dermatitis with respect to the hygiene hypothesis.
A large part of this immune education is provided by factors transmitted from the mother pre-natally through the placenta or post-natally via the breast milk. Breast milk contains a number of nutrients and bioactive components, including immune cells, maternal antibodies (mainly secretory IgA), cytokines, growth factors, lactoferrin, nucleotides, triacylglycerols, fatty acids, oligosaccharides, and vitamins. All together, these components beneficially impact the health status of the newborn, conferring, among other functions, immune education and early protection.
A typical example of such transfer of immune competence is the TGF-β that could be transmitted in active from either through the placenta or absorbed by the neonates through the milk. This TGF-β is an important IgA switch factor and this is likely to be responsible, in part, for the capacity of breast-fed infant to produce higher levels of mucosal SIgA compared to non-breast fed infants. Moreover, milk soluble CD14 transmitted to the newborn contributes to prime the neonatal gut to modulate the microbial recognition and establishment of endogenous microbiota.
Diarrhea episodes are major manifestation of common infant infections of viral or bacterial aetiology and are a key health concern in paediatrics. As mentioned above there are evidences that some probiotic strains significantly improve diarrheal outcomes in infants, particularly rotavirus diarrhea. In that respect diarrhea occurrence was selected as the primary outcome in the present trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| oral supplement1 | Experimental | Oral supplement for pregnant and lactating mothers |
|
| oral supplement 2 | Active Comparator | Oral supplement for pregnant and lactating mothers |
|
| Reference | No Intervention | No oral supplementation during pregnancy and lactating. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| milk supplement 1 | Dietary Supplement | milk supplement with probiotics |
|
| Measure | Description | Time Frame |
|---|---|---|
| The incidence of diarrhea in infants from birth to 1 year | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| In infants: growth, morbidity, immune maturation, metabolomics profile | 18 months | |
| In mothers: fetal growth, general health, immune system, metabolomics profile and preterm delivery | 18 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dr. Valerie Guinto, MD | University of the Philippines | Principal Investigator |
| Dr. Jacinto Mantaring, MD | University of the Philippines | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ospital Ng Muntinlupa | Manila | Philippines |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29855271 | Derived | Mantaring J, Benyacoub J, Destura R, Pecquet S, Vidal K, Volger S, Guinto V. Effect of maternal supplement beverage with and without probiotics during pregnancy and lactation on maternal and infant health: a randomized controlled trial in the Philippines. BMC Pregnancy Childbirth. 2018 May 31;18(1):193. doi: 10.1186/s12884-018-1828-8. |
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| ID | Term |
|---|---|
| D003967 | Diarrhea |
| D001942 | Breast Feeding |
| D007239 | Infections |
| ID | Term |
|---|---|
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D005247 | Feeding Behavior |
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| ID | Term |
|---|---|
| D020073 | Gravidity |
| ID | Term |
|---|---|
| D055703 | Reproductive Physiological Phenomena |
| D012101 | Reproductive and Urinary Physiological Phenomena |
| D011247 | Pregnancy |
| D012098 | Reproduction |
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| milk supplement 2 | Dietary Supplement | milk supplement without probiotics |
|
|
| D001519 | Behavior |
| D017584 | Reproductive History |
| D015981 | Epidemiologic Factors |
| D011634 | Public Health |
| D004778 | Environment and Public Health |