UK: Supplementation with probiotics, myo-inositol, and micronutrients in pregnancy and during preconception does not improve gestational blood sugar but may reduce preterm birth, finds a recent study. The findings of the study are published in the journal Diabetes Care.
Better metabolic and nutritional health during preconception is hypothesized to reduce preterm birth and promote gestational normoglycemia but there is limited evidence that supports improved outcomes with nutritional supplementation starting preconception. To determine the same, Keith M. Godfrey, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, U.K, and colleagues performed double-blind randomized controlled trial.
1,729 participants in the trial were recruited from the community, including U.K., Singapore, and New Zealand women aged 18–38 years planning conception. The researchers 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).
Participants were randomized to control (n = 859) or intervention (n = 870); 585 conceived within 1 year and completed the primary outcome (295 intervention, 290 control).
Key findings of the study include:
In an intention-to-treat analysis adjusting for site, ethnicity, and preconception glycemia with prespecified for multiplicity, there were no differences in gestational fasting, 1-h, and 2-h glycemia between groups (β loge mmol/L intervention vs. control −0.004, 0.025, 0.040 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), birth weight (adjusted β = 0.05 kg), or gestational age at birth (mean 39.3 vs. 39.2 weeks, adjusted β = 0.20), but there were fewer preterm births (5.8% vs. 9.2%, aRR 0.43), adjusting for prespecified covariates.
"Supplementation with myo-inositol, probiotics, and micronutrients preconception and in pregnancy did not lower gestational glycemia but did reduce preterm birth," wrote the authors.
Reference:
The study titled, "Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial," is published in the journal Diabetes Care.
DOI: https://care.diabetesjournals.org/content/early/2021/03/08/dc20-2515