A randomised control trial of low glycaemic index carbohydrate diet versus no dietary intervention in the prevention of recurrence of macrosomia

Abstract

BackgroundMaternal weight and maternal weight gain during pregnancy exert a significant influence on infant birth weight and the incidence of macrosomia. Fetal macrosomia is associated with an increase in both adverse obstetric and neonatal outcome, and also confers a future risk of childhood obesity. Studies have shown that a low glycaemic diet is associated with lower birth weights, however these studies have been small and not randomised [1,2]. Fetal macrosomia recurs in a second pregnancy in one third of women, and maternal weight influences this recurrence risk [3].Methods/DesignWe propose a randomised control trial of low glycaemic index carbohydrate diet vs. no dietary intervention in the prevention of recurrence of fetal macrosomia.Secundigravid women whose first baby was macrosomic, defined as a birth weight greater than 4000 g will be recruited at their first antenatal visit.Patients will be randomised into two arms, a control arm which will receive no dietary intervention and a diet arm which will be commenced on a low glycaemic index diet.The primary outcome measure will be the mean birth weight centiles and ponderal indices in each group.DiscussionAltering the source of maternal dietary carbohydrate may prove to be valuable in the management of pregnancies where there has been a history of fetal macrosomia. Fetal macrosomia recurs in a second pregnancy in one third of women. This randomised control trial will investigate whether or not a low glycaemic index diet can affect this recurrence risk.Current Controlled Trials Registration NumberISRCTN54392969

Relative validity of a food frequency questionnaire to assess nutrient intake in pregnant women

“…Between Septeber 2009 and September 2010, we recruited 130 healthy pregnant women who were in the control arm of a randomised control trial of a low glycaemic index diet to prevent macrosomia in euglycaemic women (ROLO study) (Walsh et al, 2010). Women were considered 'healthy' if they were not taking prescribed medication or had any underlying condition, including diabetes mellitus.…”

Psychological predictors of dietary intentions in pregnancy

“…foods with low values on an index that accounts for both GI value and carbohydrate content) improved cardiovascular risk factors, lengthened pregnancy duration and increased infant head circumference (Rhodes et al, 2010). Further clinical trials are underway aiming to explore the impact of such diets on pregnancy outcome in obese women [the UK Pregnancies: Better Eating and Activity Trial (UPBEAT); ISRCTN 89971375] and in women who have had a previous macrosomic pregnancy (Walsh et al, 2010).…”

Impact of a Low Glycemic Index Diet in Pregnancy on Markers of Maternal and Fetal Metabolism and Inflammation

“…13 The rate of gestational diabetes in the study cohort overall, however, was low, with just 7 in the intervention and 9 in the control arm according to Carpenter and Coustan criteria (or 12 vs 18 according to the American Diabetes Association criteria). 15,16 This low rate may account for the lack of difference seen in the current analysis.…”

“…13 Women were excluded if they had any underlying medical conditions, if they were less than 18 years of age, if they had previous gestational or preexisting type 1 or type 2 diabetes, or if they were unable to give full informed consent. For the purposes of this secondary analysis, those with incomplete blood results were also excluded (n ¼ 138).…”