Effect of a low glycaemic index diet during pregnancy on maternal and cord blood metabolomic profiles: results from the ROLO randomized controlled trial

Abstract

Background Elevated post-prandial blood glucose during pregnancy has been associated with adverse pregnancy and offspring outcomes, such as maternal gestational diabetes and excessive foetal growth. The ROLO Study is a randomized controlled trial (RCT) investigating the effect of a low glycaemic index (GI) diet in pregnancy to prevent foetal macrosomia (birth weight > 4000 g). We described the impact of a low-GI diet on the maternal and feto-placental unit metabolism by studying how the ROLO intervention affected maternal and cord blood metabolomes. Methods Fasting maternal plasma samples pre- and post-intervention of 51 pregnant women and 132 cord blood samples were measured with a targeted metabolomics approach using liquid-chromatography coupled to tandem mass spectrometry. The differences between RCT groups were explored via multivariate models with covariates correction. Significance was set at Bonferroni-corrected level of 0.05. Results A total of 262 metabolites species, sums and ratios were investigated. While no metabolite reached statistical significance after Bonferroni correction, many maternal phospholipids and acylcarnitines were elevated in the intervention group at uncorrected 0.05 alpha level. Most species contained saturated and monounsaturated fatty acid chains with 16 or 18 carbon atoms. In cord blood, no differences were identified between RCT groups. Conclusions A low-GI diet in pregnancy was associated with a trend to modest but consistent changes in maternal lipid and fatty acid metabolism. The intervention seemed not to affect foetal metabolism. Our exploratory findings may be used to direct further investigations about low GI diets before and during pregnancy, to improve patient care for pre-conceptional and pregnant women with lipid dysregulations and potentially modulate the offspring’s risk for future metabolic diseases. Trial registration Current Controlled Trials ISRCTN54392969 . Electronic supplementary material The online version of this article (10.1186/s12986-019-0378-z) contains supplementary material, which is available to authorized users.

Nutrients that modulate gestational diabetes mellitus: A systematic review of cohort studies Jan 2019‐Jan 2020

“…A low‐GI diet was associated with a trend to small but clear changes in maternal lipid and fatty acid metabolism but did not seem to affect foetal metabolism. This study may well be used in the future to direct further research 43 …”

Caesarean section, but not induction of labour, is associated with major changes in cord blood metabolome

“…136 cord blood samples were measured with a targeted approach at the laboratory of the Division of Metabolic and Nutritional Medicine, von Hauner Children’s Hospital, University of Munich, Germany. Metabolites were measured as previously described 16 (see also supplemental material for details).…”

“…Logged metabolite concentrations were used as dependent variables and mode of delivery (SVD, PCS or IOL) as independent variable in a linear mixed model with random intercept for the batch number (to adjust for batch effects). RCT was not included as model covariate since all groups showed similar proportions of mothers in the intervention and control arms (see results section), and since cord metabolome was not affected by the intervention 16 . The following sensitivity analyses were performed: (1) gestational age (GA), child sex, birth weight and maternal BMI were included one by one as additional covariates; (2) the highest and lowest 2.5% of each metabolite were removed (95% central data); (3) IOL babies born before the 40 th gestational week were excluded.…”

Association of Maternal Diet during Pregnancy and Metabolite Profile in Cord Blood

“…Others have identified metabolic profiles associated with unfavorable birth outcomes [ 27 , 28 , 29 , 30 ]. However, there is limited evidence on the impact of maternal diet on cord blood metabolites [ 31 ]. Thus, in the present study, we applied targeted metabolomics in order to investigate the association of maternal dietary patterns during pregnancy with cord blood metabolites.…”