Human milk composition in women with gestational diabetes mellitus: a systematic review and meta-analysis

Abstract Background Gestational diabetes mellitus (GDM) is a prevalent pregnancy disorder. In recent years, numerous studies have affirmed the augmented risk of obesity and diabetes mellitus in the offspring of affected individuals. Exclusive breastfeeding has been vigorously advocated as an infant feeding practice in various countries. We aimed to test our hypothesis that human milk of women with gestational diabetes differs from that of non-GDM women. Methods For this systematic review and meta-analysis, we searched the CNKI, PubMed, Web of Science databases, and citations for studies published between Jan 1,2000 and Sep 26, 2024. We included all studies related to human milk macronutrients. We did separate meta-analyses for carbohydrates, proteins, lipids, and energy of the colostrum and mature human milk. All analyses were performed using Revman 5.4.1 (Review Manager). The quality of the evidence was assessed with the NOS scale. Registration does not apply. Findings Of 377 records identified, 9 records were available, all of which had a moderate to high quality. Compared to non-GDM women, the colostrum of GDM women exhibited a higher protein content (MD = 0.04, 95% CI: 0.00~0.07, P = 0.03), while there were no significant disparities in carbohydrates, lipids, and energy. Simultaneously, the mature human milk of GDM women had a higher protein content (MD = 0.01, 95% CI: 0.00~0.02, P = 0.007) and a higher lipid content (MD = 0.19, 95% CI: 0.08~0.31, P = 0.001), with no significant differences in carbohydrates and energy. Interpretation There are many factors affecting the composition of human milk and fewer studies have been conducted on the composition of human milk. More high-quality studies are needed to validate the relationship between macronutrients in colostrum and carbohydrate in mature milk content with GDM.