Abstract
BackgroundElevated post-prandial blood glucose during pregnancy has been associated with adverse pregnancy and offspring outcomes, such as maternal gestational diabetes and excessive foetal growth. The ROLO Study is a randomized controlled trial (RCT) investigating the effect of a low glycaemic index (GI) diet in pregnancy to prevent foetal macrosomia (birth weight > 4000 g). We described the impact of a low-GI diet on the maternal and feto-placental unit metabolism by studying how the ROLO intervention affected maternal and cord blood metabolomes.MethodsFasting maternal plasma samples pre- and post-intervention of 51 pregnant women and 132 cord blood samples were measured with a targeted metabolomics approach using liquid-chromatography coupled to tandem mass spectrometry. The differences between RCT groups were explored via multivariate models with covariates correction. Significance was set at Bonferroni-corrected level of 0.05.ResultsA total of 262 metabolites species, sums and ratios were investigated. While no metabolite reached statistical significance after Bonferroni correction, many maternal phospholipids and acylcarnitines were elevated in the intervention group at uncorrected 0.05 alpha level. Most species contained saturated and monounsaturated fatty acid chains with 16 or 18 carbon atoms. In cord blood, no differences were identified between RCT groups.ConclusionsA low-GI diet in pregnancy was associated with a trend to modest but consistent changes in maternal lipid and fatty acid metabolism. The intervention seemed not to affect foetal metabolism. Our exploratory findings may be used to direct further investigations about low GI diets before and during pregnancy, to improve patient care for pre-conceptional and pregnant women with lipid dysregulations and potentially modulate the offspring’s risk for future metabolic diseases.Trial registrationCurrent Controlled Trials ISRCTN54392969.
Highlights
Elevated post-prandial blood glucose during pregnancy has been associated with adverse pregnancy and offspring outcomes, such as maternal gestational diabetes and excessive foetal growth
Gestational weight gain (GWG) was defined as weight at last measured visit (38th or 40th gestational week) after subtraction of early pregnancy weight; for cases with missing weight at 38th or 40th week, gestational weight gain (GWG) was imputed by adding the overall ROLO median GWG between 34th and 38th week to the weight measured at 34th week
In this study, we explored the impact of a dietary intervention promoting a low-glycaemic index (GI) diet during pregnancy on the metabolome of pregnant women and cord blood of their offspring
Summary
Elevated post-prandial blood glucose during pregnancy has been associated with adverse pregnancy and offspring outcomes, such as maternal gestational diabetes and excessive foetal growth. The ROLO Study is a randomized controlled trial (RCT) investigating the effect of a low glycaemic index (GI) diet in pregnancy to prevent foetal macrosomia (birth weight > 4000 g). Pregnancy is a period of major endocrine and metabolic changes which modulate both maternal and child’s health [10] Pregnancy exposures such as gestational diabetes mellitus (GDM), elevated maternal pre-pregnancy body-mass-index (BMI) and gestational weight gain (GWG) are risk factors for type 2 diabetes, overweight, and metabolic syndrome in the mother [3, 10, 27] and in the offspring, as suggested by the numerous indications for the Developmental Origins of Health and Disease (DOHaD) hypothesis [12, 24]. The GI of a carbohydrate-containing food, expressed on a scale from 0 to 100, quantifies the peak in the blood sugar concentrations after ingestion of the food [25]; the consumption of low GI foods is considered desirable to achieve good glycaemic control
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