Lutein Concentrations in Preterm Human Milk and Retinopathy of Prematurity –
a Prospective Observational Study

Objectives: Retinopathy of prematurity (ROP), a major cause of visual impairment and blindness, is a retinal neovascular disorder affecting preterm infants (PTI). Oxidative stress has been implicated in the pathogenesis of ROP. Lutein, the major carotenoid found in the human eye, is thought to have a protective role against oxidative and light damage. Lutein is supplied to PTI by human milk (HM). We conducted this prospective study to investigate the correlation between lutein levels in HM and the occurrence and severity of ROP in PTI. We performed a longitudinal analysis of carotenoids: Lutein, Zeaxanthin, Beta-Carotene and Lycopene, in preterm HM.

Methods: Healthy exclusively lactating mothers of PTI born at gestational age 24+2 weeks to 29+6 weeks or with birth-weight under 1500grams were recruited. Participant provided up to 7 HM samples (2-10ml) at day 0-3 (Colostrum), and once a week until 6 weeks. A plasma sample was prepared from 1ml blood collected from the infant at week 6, during NICU routine blood test when available. Samples were analyzed by modified HPLC methodologies at IFF Health.

Results: Included were 39 mother-infant-dyads, enrolled between 2018 and 2020, who generated 184 HM samples and 22 plasma samples. Seven infants developed ROP. Lutein, zeaxanthin, beta-carotene and lycopene concentration decreased as lactation progressed. There were no correlation between lutein levels in HM samples and ROP (e.g. at week 2, p=.757 and at week 4, p=.276). Plasma beta-carotene and lycopene levels correlated with those seen in HM samples at week 6 (p

Conclusion: There were no correlation between the occurrence of ROP and the lutein content in preterm HM during the first 6 weeks of lactation.