Maternal Nutrition during Early Pregnancy and Cardiometabolic Status of Neonates at Birth

Abstract

Objective To explore the impact of maternal body weight on maternal nutrition and micronutrient status in early pregnancy and potential impact on metabolic status in newborns. Methodology The EU FP7 project GIFTS was conducted from Jan 2012 to May 2014. Demographic details and anthropometric measurements of women in the first trimester of pregnancy were obtained. Blood samples were collected for OGTT, insulin, lipid profile, serum folate, ferritin, vitamin D, vitamin B12, and red cell folate. Newborn anthropometric characteristics were observed. Cord blood samples were collected after delivery for glucose, insulin, and lipid profile of newborns. Results A total of 301 pregnant mothers, 108 overweight, 63 underweight, and 130 normal weight were included. Prevalence of vitamin D deficiency (<30 ng/mL) and low vitamin B12 (<190 ng/l) were high, 44% and 42%, respectively, in the first trimester. Anemic women (due to B12 or iron deficiency) were 79%, while 72% had low ferritin levels. Gestational diabetes was 16%. Differences were observed between underweight and overweight mothers (P < 0.05) for fasting blood glucose, insulin levels, and serum ferritin were observed. No significant difference was observed between vitamin D, serum B12, and red cell folate levels. Conclusion Prevalence of multiple micronutrient deficiencies was common among Pakistani women during early pregnancy despite the nonvegetarian diet that has important implications for pregnancy care in Pakistan and potentially in expatriate communities living abroad. This trial is registered with ISRCTN number 83599025.

Maternal BMI and nutritional status in early pregnancy and its impact on neonatal outcomes at birth in Bangladesh

“…Our data showed a high prevalence of vitamin D deficiency and insufficiency in pregnant women in early pregnancy. Studies in Pakistan with identical definition for vitamin D deficiency with similar inclusion criteria had shown similar results [15, 32]. Similar findings were also observed in other studies conducted in Bangladesh [33] and India [34].…”

“…This is one of several sub studies of a prospective multi-center EU FP7 project GIFTS (Genomic and lifestyle predictors of fetal outcome relevant to diabetes and obesity and their relevance to prevention strategies in South Asian peoples) project conducted from April 2011 and June 2012 in Dhaka, Bangladesh. Other GIFTS studies included analysis of other populations in Pakistan [15] and Bangladeshi’s in the UK, a micronutrient intervention study in pregnancy in Dhaka (ISRCTN Number: 83599025), genomic predictors of birthweight and gestational diabetes (GDM) in South Asian populations, analysis of body composition in Bangladeshi children aged 2–4 in whose mothers were exposed to a community mobilization program [16], studies in GDM [17–19] and social and cultural influences of South Asian women during pregnancy [20].…”

“…This was done to avoid high dropout rate because of 3 blood measures in pregnancy. GDM was defined as a fasting plasma glucose (FPG) ≥5.1 mmol/L or plasma glucose ≥8.5 mmol/L 2 hours after ingesting 75 g glucose (2hPG) [15]. Diabetes in pregnancy was defined as a FPG ≥7.0 mmol/L or 2hPG ≥11.1 mmol/L [22].…”

Iron Deficiency and Iron Deficiency Anemia: Implications and Impact in Pregnancy, Fetal Development, and Early Childhood Parameters

“…ID may also be a marker for other nutritional issues. In a study from Pakistan, underweight women in early pregnancy had lower serum ferritin concentrations than either normal body weight or overweight mothers [75].…”

Vitamin B12 deficiency and altered one-carbon metabolites in early pregnancy is associated with maternal obesity and dyslipidaemia

“…In children and adolescents, increase in BMI 13 and IR 14 have been associated with low B12 levels. Furthermore, studies in early pregnancy have focussed on association between lower maternal micronutrient status (B12, folate, iron) with pre-pregnancy overweight and obesity in mothers 15,16,17 , with lower micronutrients in low-birth weight infants 18 and with higher BMI and heart rate in children at age 5-6 19 . Our in vitro studies have shown that B12 deficiency in adipocytes altered DNA methylation levels 2 of the transcription factors of lipid regulation 2 and the adipose derived miRNAs targeting IR 3 thereby suggesting that B12 deficiency dysregulates epigenetic mechanisms.…”