The influence of maternal glycaemia and dietary glycaemic index on pregnancy outcome in healthy mothers

Abstract

Infant birth weight has increased in Ireland in recent years along with levels of childhood overweight and obesity. The present article reviews the current literature on maternal glycaemia and the role of the dietary glycaemic index (GI) and its impact on pregnancy outcomes. It is known that maternal weight and weight gain significantly influence infant birth weight. Fetal macrosomia (birth weight >4000 g) is associated with an increased risk of perinatal trauma to both mother and infant. Furthermore, macrosomic infants have greater risk of being obese in childhood, adolescence and adulthood compared to normal-sized infants. There is evidence that there is a direct relationship between maternal blood glucose levels during pregnancy and fetal growth and size at birth, even when maternal blood glucose levels are within their normal range. Thus, maintaining blood glucose concentrations within normal parameters during pregnancy may reduce the incidence of fetal macrosomia. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations. However, different CHO foods produce different glycaemic responses. The GI was conceived by Jenkins in 1981 as a method for assessing the glycaemic responses of different CHO. Data from clinical studies in healthy pregnant women have documented that consuming a low-GI diet during pregnancy reduces peaks in postprandial glucose levels and normalises infant birth weight. Pregnancy is a physiological condition where the GI may be of particular relevance as glucose is the primary fuel for fetal growth.

Maternal low glycaemic index diet, fat intake and postprandial glucose influences neonatal adiposity – secondary analysis from the ROLO study

“…Macrosomic infants are at increased risk of developing metabolic syndrome in later life and this effect may persist in later generations through intergenerational programming [8]. Macrosomia also increases obstetric risks such as shoulder dystocia, maternal anal sphincter injury, instrumental vaginal delivery and emergency caesarean section [9]. …”

The influence of a low glycemic index dietary intervention on maternal dietary intake, glycemic index and gestational weight gain during pregnancy: a randomized controlled trial

“…There is also evidence that maternal weight and maternal gestational weight gain (GWG) exert a profound influence on infant birthweight. One of the main environmental factors regulating fetal growth is maternal substrate delivery to the placenta; thus, factors that modify maternal blood glucose levels can alter the rate of fetal growth [3,4]. Maternal diet, and particularly its carbohydrate (CHO) type and content, influences maternal blood glucose concentrations.…”

Maternal Dietary Nutrient Intake and Risk of Preterm Delivery

“…25 Its investigation is plausible, however, given that increasing glucose levels, within ranges below levels that are diagnostic of diabetes, have been associated with preterm delivery, 26 and dietary glycemic index correlates with glycemic control in pregnant women. 27 As noted, several studies have examined the association of folate with preterm delivery, but other nutrients involved in one-carbon metabolism (e.g., other B vitamins, methionine) have not to our knowledge been investigated.…”