Associations Between Human Milk Oligosaccharides at One Month and Infant Development Throughout the First Year of Life in a Brazilian Cohort.

Background Human milk oligosaccharides (HMOs) are unconjugated glycans associated with infant health and development. Objective To investigate the associations between HMO concentrations at one month and infant development throughout the first year of life. Methods A prospective cohort of Brazilian women between 18-40 years of age and their infants was studied from baseline (between 28-35 gestational weeks) and followed at one (n = 73), six (n = 51), and twelve months (n = 45). A total of 19 HMOs were quantified by high-performance liquid chromatography with fluorescence detection. Infant development was evaluated by Ages & Stages Questionnaires (ASQ-BR). A directed acyclic graph was used to define the minimally sufficient adjustment (gestational age at birth, gestational weight gain, prepregnancy BMI, maternal age, parity, and the mode of breastfeeding at one month). Cox regression models with hazard ratios and Benjamini-Hochberg multiple corrections were performed to estimate associations of HMOs with the cumulative risk of inadequate development for 5 developmental domains or for ≥ 2 developmental domains in all women and in the subset of secretor women (defined as the presence or near absence of 2'FL and INFP I). Results The multivariate models with multiple corrections revealed an inverse association between lacto-N-tetrose (LNT) and the risk of inadequate development for personal-social skills (0.06; 95% CI: 0.01, 0.76) and for ≥ 2 developmental domains (0.06; 95% CI: 0.01, 0.59). The secretor mothers analysis also showed inverse associations with slightly different results: personal-social skills (0.09; 95% CI: 0.02, 0.84) and ≥ 2 developmental domains (0.05; 95% CI: 0.01, 0.70). Conclusion Higher concentrations of LNT HMOs in Brazilian women are associated with their infants being less likely to be at risk of inadequate development for personal-social skills or for ≥ 2 developmental domains during the first year of life.