A systematic review of maternal and neonatal sialic acid status and infant neural development

Objective: Sialic acids and sialoconjugates such as gangliosides (GA) are crucial in early neural development and could further impact cognitive function. The current review summarizes the nutritional status and variation trend of sialic acid during pregnancy and the perinatal period, explores sialic acid status's potential impact on neonatal growth and development, especially neurocognitive function, and concludes the existing evidence of relevant interventional studies.

Methods: We searched and collected relevant publications in English and Chinese published from January 2000 to September 2022 from mainstream databases, including PubMed, Embase, CNKI, WanFang, VIP, etc. The current review included five interventional studies and 19 correlational studies.

Results: Maternal serum total sialic acid (TSA) elevates as the gestational age increases. In contrast, breast milk TSA reduces over time. Several studies found a significant positive correlation between maternal serum TSA, breast milk TSA, and cord blood TSA significantly correlated with newborns' mental developmental index (MDI) and physical development index (PDI). TSA in preterm breastmilk was higher than that of term breastmilk, possibly to meet the more critical demand for neural development of preterm infants. Significant differences in the composition and concentration of GA were found between breastmilk and formula. Results from interventional studies showed GA-enriched-formula-fed infants had better mental development levels than regular-formula-fed controls, but did not differ from breastfed references.

Conclusions: Based on the current evidence body, it is necessary to emphasize the importance of maternal sialic acid status and further investigate its influencing factors.