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https://doi.org/10.2337/dc20-2515
Title: | Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial | Authors: | Godfrey, Keith M Barton, Sheila J El-Heis, Sarah Kenealy, Timothy Nield, Heidi Baker, Philip N Chong, Yap Seng Cutfield, Wayne Chan, Shiao-Yng |
Keywords: | Science & Technology Life Sciences & Biomedicine Endocrinology & Metabolism GESTATIONAL DIABETES-MELLITUS PRETERM BIRTH HYPERGLYCEMIA GLUCOSE INTERVENTION ASSOCIATIONS WEIGHT HEALTH GROWTH MODEL |
Issue Date: | 1-May-2021 | Publisher: | AMER DIABETES ASSOC | Citation: | Godfrey, Keith M, Barton, Sheila J, El-Heis, Sarah, Kenealy, Timothy, Nield, Heidi, Baker, Philip N, Chong, Yap Seng, Cutfield, Wayne, Chan, Shiao-Yng (2021-05-01). Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial. DIABETES CARE 44 (5) : 1091-1099. ScholarBank@NUS Repository. https://doi.org/10.2337/dc20-2515 | Abstract: | OBJECTIVE Better preconception metabolic and nutritional health are hypothesized to promote gestational normoglycemia and reduce preterm birth, but evidence supporting improved outcomes with nutritional supplementation starting preconception is limited. RESEARCH DESIGN AND METHODS This double-blind randomized controlled trial recruited from the community 1,729 U.K., Singapore, and New Zealand women aged 18–38 years planning conception. We investigated whether a nutritional formulation containing myo-inositol, probiotics, and multiple micronutrients (intervention), compared with a standard micronutrient supplement (control), taken preconception and throughout pregnancy could improve pregnancy outcomes. The primary outcome was combined fasting, 1-h, and 2-h postload glycemia (28 weeks’ gestation oral glucose tolerance test). RESULTS Between 2015 and 2017, participants were randomized to control (n 5 859) or intervention (n 5 870); 585 conceived within 1 year and completed the primary outcome (295 intervention, 290 control). In an intention-to-treat analysis adjusting for site, ethnicity, and preconception glycemia with prespecified P < 0.017 for multiplicity, there were no differences in gestational fasting, 1-h, and 2-h glycemia between groups (β [95% CI] loge mmol/L intervention vs. control 0.004 [ 0.018 to 0.011], 0.025 [ 0.014 to 0.064], 0.040 [0.004–0.077], respectively). Between the intervention and control groups there were no significant differences in gestational diabetes mellitus (24.8% vs. 22.6%, adjusted risk ratio [aRR] 1.22 [0.92–1.62]), birth weight (adjusted β 5 0.05 kg [ 0.03 to 0.13]), or gestational age at birth (mean 39.3 vs. 39.2 weeks, adjusted β 5 0.20 [ 0.06 to 0.46]), but there were fewer preterm births (5.8% vs. 9.2%, aRR 0.43 [0.22–0.82]), adjusting for prespecified covariates. CONCLUSIONS Supplementation with myo-inositol, probiotics, and micronutrients preconception and in pregnancy did not lower gestational glycemia but did reduce preterm birth. | Source Title: | DIABETES CARE | URI: | https://scholarbank.nus.edu.sg/handle/10635/216312 | ISSN: | 01495992 19355548 |
DOI: | 10.2337/dc20-2515 |
Appears in Collections: | Staff Publications Elements |
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