Influence of glucocorticoid and betamimetic therapy on milk secretory IgA concentration produced by mothers delivering preterm infants

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Abstract
A prospective study was performed to find the possible difference in secretory IgA concentration in milk from mothers with term pregnancy and those delivering at earlier gestational ages. Since tocolytgic drugs and/orglucocorticoid agents are usually given in cases of threatened premature labor, the preterm group was divided into mothers with or without medication. Mothers (32) were distributed in 3 groups: group I, mothers with preterm labors without any medication; group II, preterm labors with previous treatment with betamimetics and glucocorticoids and group III, term labors. In each of the 3 groups, three periods were studied: colostral (4 to 5 days postpartum), transitional (8 to 10 days), and mature (14 50 15 days). All mothers were healthy, with good nutritional state, without local inflammation and having membranes that had ruptured 12 h or less before labor. There was no significant difference in the proportion of primiparas and multiparas in both groups. The gestational age was evaluated by amenorrhea and neonatal examination. In all mothers milk was extracted with a vacuum pump to empty the mammary gland. The determinations were made using a specific antibody against the secretory component. The concentration of the free secretory component in these milks was practically insignificant. No differences were found in the concentration of secretory IgA among the 3 groups in the periods that were studied, colostral, transitional or mature. The greater the period of the between labor and milk extraction, there was a progressive decrease in the concentration of secretory IgA. No evidence was found showing that medication given to the mother during the hours before delivery affects the concentration of secretory IgA in milk. This knowledge, together with information previously described regarding composition of preterm mother''s milk, supports the statement that preterm neonates may be fed with their own mother''s milk.