Plasma and breast milk adipokines in women across the first year postpartum and their association with maternal depressive symptoms and infant neurodevelopment: Protocol for the APPLE prospective cohort study

PLoS One. 2024 Oct 25;19(10):e0310847. doi: 10.1371/journal.pone.0310847. eCollection 2024.

Abstract

Introduction: Adiponectin and leptin play important roles in the central nervous system. During the postpartum period, there is a need for a better understanding of the relationship between these cytokines and the neurological development of the infant, as well as their influence on preventing maternal depressive symptoms.

Objectives: To assess the correlation between adiponectin and leptin in maternal plasma and breast milk and their association with: infant neurodevelopment at 6 and 12 months of age; and maternal mental health over the first year postpartum.

Methods: Prospective cohort study with four follow-up. Mothers and their newborns are recruited within the first 15 days postpartum (baseline). Follow-up visits occur at 2, 6, and 12 months postpartum. Visits include blood and breast milk collection, application of the Edinburgh Postnatal Depression Scale and Beck Depression Inventory to assess maternal mental health, application of the Bayley-III scale for infant developmental assessment, maternal and infant anthropometry and body composition, evaluation of reproductive history, mother-infant bonding, breastfeeding, consumption of ultra-processed foods, sleep quality, and socio-economic and demographic data.

Results: The research received funds in August 2022, and participant recruitment began in September 2022. The sample size will consist of 95 mother-child pairs. As of September 2023, 68 participants have been recruited.

Conclusion: The project will provide insights into the association between adiponectin and leptin with postpartum depression and infant neurodevelopment, ultimately promoting improved care and quality of life for these groups. Additionally, it will provide data on the type of delivery, infant physical growth, maternal and infant body composition changes, sleep quality, consumption of ultra-processed foods, and maternal metabolic health, including vitamin D metabolites, oxidized polyunsaturated fatty acid metabolites, phospholipid species and triacylglycerols, which are of significant relevance to public health and, when interconnected, may yield important results and contribute to the existing literature.

Trial registration: Name of the registry: Brazilian Clinical Trials Registry (ReBec). Registration number: RBR-9hcby8c.

MeSH terms

  • Adipokines / blood
  • Adipokines / metabolism
  • Adiponectin* / blood
  • Adult
  • Breast Feeding
  • Child Development*
  • Depression, Postpartum* / blood
  • Depression, Postpartum* / epidemiology
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Leptin / blood
  • Leptin / metabolism
  • Milk, Human* / chemistry
  • Milk, Human* / metabolism
  • Mothers / psychology
  • Postpartum Period* / blood
  • Postpartum Period* / psychology
  • Prospective Studies

Substances

  • Adiponectin
  • Leptin
  • Adipokines

Grants and funding

The project is being funded by the Research Support Program (APQ-1) of the Rio de Janeiro State Research Support Foundation (FAPERJ Proc. No. 211.557/2021). Participant reimbursement is being provided with support from the Research Productivity Fellowship from the National Council for Scientific and Technological Development (CNPq) under the name of AEN. COM, LGR and TMT receive scholarships from Coordination for the Improvement of Higher Education Personnel (CAPES). MTNR receives a scholarship from CNPq. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.