Five‐year follow up of a low glycaemic index dietary randomised controlled trial in pregnancy—no long‐term maternal effects of a dietary intervention

Abstract

Objective To determine whether a dietary intervention in pregnancy had a lasting effect on maternal outcomes of diet, HbA1c and weight retention 5 years post‐intervention; and to establish whether modifiable maternal behaviours were associated with these outcomes. Design Randomised control trial of low glycaemic index (GI) diet in pregnancy with longitudinal follow up to 5 years post‐intervention. Setting Dublin, Ireland (2007–2016). Population In all, 403 women of 759 (53.1%) were followed up at 5 years. A total of 370 (intervention n = 188; control n = 182) were included in this analysis. Methods Fasting glucose was measured at 13 and 28 weeks’ gestation and HbA1c (mmol/mol) at 5‐year follow up. Weight retention (kg) from early pregnancy to 5 years post‐intervention was calculated. Dietary intakes, anthropometry, and lifestyle factors were measured in pregnancy and 5 years post‐intervention. Multiple linear regression models, controlling for confounders, were used for analysis. Outcome Maternal diet, HbA1c, and weight retention at 5 years post‐intervention. Results There was no difference between the intervention and control at 5 years post‐intervention for any long‐term maternal outcomes measured. HbA1c at 5 years post‐intervention was associated with early‐pregnancy fasting glucose (B 1.70, 95% CI 0.36–3.04) and parity ≥3 (B 1.04, 95% CI 0.09–1.99). Weight retention was associated with change in well‐being from pregnancy to 5 years (B −0.06, 95% CI −0.11 to −0.02), gestational weight gain (B 0.19, 95% CI 0.00–0.38), and GI (B 0.26, 95% CI 0.06–0.46) at 5 years. Conclusions The ROLO low‐GI dietary intervention in pregnancy had no impact on maternal dietary intakes, HbA1c or body composition 5 years post‐intervention. Maternal factors and lifestyle behaviours in pregnancy have long‐term effects on glucose metabolism and weight retention up to 5 years later. Tweetable abstract Pregnancy factors are associated with maternal glucose metabolism and weight retention 5 years later—findings from the ROLO Study.

Blood pressure in pregnancy—A stress test for hypertension? Five‐year, prospective, follow‐up of the ROLO study

“…Similar findings were described for other maternal characteristics within the ROLO cohort, investigated elsewhere. 4 This finding also suggests that although the ROLO study had positive effects of GWG, this did not have a lasting impact on BP, as suggested in previous research. 26 Body mass index at early pregnancy and weight at the 5-year follow-up were associated with HTN stage 1 at the 5-year follow-up.…”

“…This nonsignificant finding could be explained by these women already being identified as high risk for future HTN and thus managed with pharmacological treatment. Similar findings were described for other maternal characteristics within the ROLO cohort, investigated elsewhere 4. Although SBP and DBP are routinely measured in pregnancy, MAP is rarely calculated in clinical practice 24.…”

A high dietary fiber randomized clinical trial reduces gestational weight gain, fat accrual, and postpartum weight retention

“…A small benefit was found on maternal insulin levels early in pregnancy only, however, no effect was found for leptin or markers of inflammation. Follow-up data from the ROLO trial during the first six months and five-years postpartum found a limited sustained intervention effect [37][38][39] . Greater weight loss was found at three months postpartum, however, this difference was not detected at six months or five years postpartum.…”

PREgnancy Nutrition: A protocol for the development of a Core Outcome Set (PRENCOS)

“…In the initial email invitation, stakeholder‐specific information will be included outlining the project background, the Delphi purpose and process, and the potential impact of their participation on nutrition research within this population group . The survey will be disseminated using DelphiManager ™ software (developed by the COMET initiative) .…”

“…Maternal nutrition during pregnancy can affect maternal health during pregnancy and beyond . It also influences the intrauterine environment of the developing fetus and this may influence the health and development of children in utero right through to adulthood . Therefore, nutrition during pregnancy is an important consideration in the management of pregnant women and in the overall life course approach to health care and health promotion.…”