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- Background and objective: Human milk oligosaccharides (HMOs) are carbohydrates abundant in human breast milk. Their composition varies widely among women, and prior research has identified numerous factors contributing to this variation. However, the impact of maternal psychological health on HMOs is currently unknown. Thus, this study aimed to identify whether maternal stress, anxiety, or depressive symptoms are associated with HMOs.
Methods: Data originated from the UC San Diego Human Milk Biorepository. 19 prevalent HMOs were assayed using high performance liquid chromatography. Participants self-reported measures of the Edinburgh Depression Scale (EPDS), State-Trait Anxiety Inventory S-Scale (STAI-S), and/or Perceived Stress Scale (PSS) within 60 days of their milk collection, and their results were categorized using standard screening cutoffs. HMOs were assessed individually and by principal components analysis (PCA) and associations with maternal psychological symptoms were analyzed using multivariable linear regression adjusted for infant sex, exclusive breastfeeding, infant age at milk collection, maternal age, race, depression and anxiety medications, and maternal body mass index.
Results: The sample consisted of those with complete measures of the EPDS (n = 495), STAI-S (n = 486), and/or PSS (n = 493). 11.5% screened positive for depressive symptoms, 14.4% for anxiety symptoms, and 25.2% for stress. After applying Bonferroni correction for multiple comparisons (P<0.002), the following HMOs were significantly associated with maternal psychological distress in multivariate analysis: lacto-N-fucopentaose III (LNFP III) and lacto-N-hexaose (LNH) among Secretors with depressive symptoms, and difucosyllactose (DFLac), LNFP III, and disialyl-LNH (DSLNH) among Secretors with stress. In PCA, depressive symptoms and stress were associated with one principal component among Secretors. No HMOs varied with anxiety symptoms.
Conclusions: Several HMOs varied with maternal depressive symptoms and stress, suggesting a possible impact of maternal psychological health on breast milk composition. Additional studies are needed to determine the impact of this variation on infant health.
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