Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study

Abstract

BackgroundIndia is experiencing an epidemic of obesity-hyperglycaemia, which coincides with child bearing age for women. The epidemic can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, we developed the protocol for the proposed birth cohort of 5000 women, the recruitment for which will start in April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia.MethodsMaternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years. The institutional review board at The Indian Institute of Public Health (IIPH)-H, Bangalore, Public Health Foundation of India has approved the protocol. All participants are required to provide written informed consent.DiscussionThe findings from this study may help to address important questions on screening and management of high blood sugar in pregnancy. It may provide critical information on the specific determinants driving the underweight-obesity-T2DM epidemic in India. The study can inform the policy regarding the potential impact of screening and management protocols in public healthcare facilities. The public health implications include prioritising issues of maternal glycemic control and weight management and better understanding of the lifecourse determinants in the development of T2DM.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1088-4) contains supplementary material, which is available to authorized users.

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“…We have published a detailed protocol earlier. 30 In brief, we approached women in the waiting area of public hospitals and explained the study in detail and included them if they voluntarily agreed to participate and provided written informed consent. We included pregnant women aged above 18 years, in their second trimester (within 36 gestational weeks) visiting and planning to deliver in three public hospitals with their residence in the nearby study area.…”

Small for gestational age babies and depressive symptoms of mothers during pregnancy: Results from a birth cohort in India

“…Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) is a birth cohort established to prospectively identify risk factors in pregnancy associated with adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases 18 . The detailed protocol of the study has been published elsewhere 18 . Briefly, pregnant women with gestational age (GA) between 14 to 32 weeks were recruited.…”

Determinants of Breastfeeding Practices and Its Association With Infant Anthropometry: Results From a Prospective Cohort Study in South India

“…Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI) is an ongoing 5-year birth cohort study undertaken to prospectively assess the effects of several factors in pregnancy on the risk of adverse maternal and infant outcomes at tertiary care public health facilities in urban Bengaluru, South India. The detailed protocol of MAASTHI has been published earlier (21).…”