Gupta Vipin, Saxena Ruchi, Walia Gagandeep Kaur, Agarwal Tripti, Vats Harsh, Dunn Warwick, Relton Caroline, Sovio Ulla, Papageorghiou Aris, Davey Smith George, Khadgawat Rajesh, Sachdeva Mohinder Pal
Department of Anthropology, University of Delhi, Delhi, India.
Department of Obstetrics and Gynaecology, Sardar Patel Medical College, Bikaner, Rajasthan, India.
BMJ Open. 2019 May 1;9(4):e025395. doi: 10.1136/bmjopen-2018-025395.
Pregnancy is characterised by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG), which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short-term and long-term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on fetal growth and newborn anthropometric traits at birth.
A prospective longitudinal study is planned (start date: February 2018; end date: March 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3 follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardised methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with fetal growth, offspring's weight and body composition at birth will be investigated using regression modelling.
The study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
妊娠的特点是从妊娠早期到晚期代谢变化率很高，以满足不断增加的生理和代谢需求。代谢物水平的这种变化受孕期体重增加（GWG）的影响，而孕期体重增加是健康妊娠的一个重要特征。GWG不足/过多对母婴健康有短期和长期影响。为了解妊娠期间代谢物水平的定量变化，需要探索妊娠代谢。因此，我们的目的是研究与GWG相关的代谢物水平在孕期各阶段的特异性变化及其对胎儿生长和出生时新生儿人体测量特征的影响。
计划对孕早期招募的孕妇进行一项前瞻性纵向研究（开始日期：2018年2月；结束日期：2023年3月），并在随后的孕期和分娩时进行随访（共3次随访）。该研究在印度拉贾斯坦邦比卡内尔区的一家医院进行（农村人口占66%）。估计样本量为1000对母婴。使用标准化方法收集每个孕期的妇科和产科病史、社会经济地位、饮食、身体活动、烟草和酒精消费、抑郁、人体测量和血样信息，用于代谢分析。混合效应回归模型将用于评估孕期体重对每个孕期代谢物水平的影响。将使用回归模型研究母亲代谢物水平与胎儿生长、后代出生体重和身体组成之间的关联。
该研究已获得德里大学人类学系和拉贾斯坦邦萨达尔·帕特尔医学院伦理委员会的批准。我们在用当地语言与参与者讨论研究的各个方面后，获取书面知情同意书。
