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Moran LJ, Fraser LM, Sundernathan T, Deussen AR, Louise J, Yelland LN, Grivell RM, Macpherson A, Gillman MW, Robinson JS, Owens JA, Dodd JM. The effect of an antenatal lifestyle intervention in overweight and obese women on circulating cardiometabolic and inflammatory biomarkers: secondary analyses from the LIMIT randomised trial. BMC Med 2017; 15:32. [PMID: 28193219 PMCID: PMC5307888 DOI: 10.1186/s12916-017-0790-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/11/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Maternal overweight and obesity during pregnancy is associated with insulin resistance, hyperglycaemia, hyperlipidaemia and a low-grade state of chronic inflammation. The aim of this pre-specified analysis of secondary outcome measures was to evaluate the effect of providing antenatal dietary and lifestyle advice on cardiometabolic and inflammatory biomarkers. METHODS We conducted a multicentre trial in which pregnant women who were overweight or obese were randomised to receive either Lifestyle Advice or Standard Care. We report a range of pre-specified secondary maternal and newborn cardiometabolic and inflammatory biomarker outcomes. Maternal whole venous blood was collected at trial entry (mean 14 weeks gestation; non-fasting), at 28 weeks gestation (fasting), and at 36 weeks gestation (non-fasting). Cord blood was collected after birth and prior to the delivery of the placenta. A range of cardiometabolic and inflammatory markers were analysed (total cholesterol, triglycerides, non-esterified fatty acids, high-density lipoprotein cholesterol, insulin, glucose, leptin, adiponectin, C-reactive protein, granulocyte macrophage-colony stimulating factor, interferon gamma, TNF-α, and interleukins 1β, 2, 4, 5, 6, 8, and 10). Participants were analysed in the groups to which they were randomised, and were included in the analyses if they had a measure at any time point. RESULTS One or more biological specimens were available from 1951 women (989 Lifestyle Advice and 962 Standard Care), with cord blood from 1174 infants (596 Lifestyle Advice and 578 Standard Care). There were no statistically significant differences in mean cardiometabolic and inflammatory marker concentrations across pregnancy and in infant cord blood between treatment groups. Estimated treatment group differences were close to zero, with 95% confidence intervals spanning a range of differences that were short of clinical relevance. There was no evidence to suggest that the intervention effect was modified by maternal BMI category. CONCLUSIONS Despite our findings, it will be worth considering potential relationships between cardiometabolic and inflammatory markers and clinical outcomes, including longer-term infant health and adiposity. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ( ACTRN12607000161426 ; Date Registered 09/03/2007).
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Affiliation(s)
- Lisa J. Moran
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
- Monash University, Monash Centre for Health Research Implementation, Clayton, Victoria Australia
| | - Louise M. Fraser
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Tulika Sundernathan
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Andrea R. Deussen
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Jennie Louise
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
- The University of Adelaide, School of Population Health, Adelaide, South Australia Australia
| | - Lisa N. Yelland
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
- The University of Adelaide, School of Population Health, Adelaide, South Australia Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia Australia
| | - Rosalie M. Grivell
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
- Flinders University, Department of Obstetrics & Gynaecology, Bedford Park, South Australia Australia
| | - Anne Macpherson
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Matthew W. Gillman
- Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, Massachusetts USA
- Environmental Influences on Child Health Outcomes (ECHO) Program, National Institutes of Health, Rockville, Maryland USA
| | - Jeffrey S. Robinson
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Julie A. Owens
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
| | - Jodie M. Dodd
- The University of Adelaide, The Robinson Research Institute, and Discipline of Obstetrics & Gynaecology, Adelaide, South Australia Australia
- The Women’s and Children’s Hospital, Women’s and Babies Division, Department of Perinatal Medicine, Adelaide, South Australia Australia
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