Maternal Metabolic and Molecular Changes Induced by Preconception Weight Loss and Their Effects on Birth Outcomes
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Shannon Considine, MPH, MSW
- Phone Number: 734-232-6483
- Email: sconsidi@umich.edu
Study Locations
-
-
Michigan
-
Ann Arbor, Michigan, United States, 48106
- University of Michigan
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- BMI > 30 ≤ 45 for obese participants OR
- BMI ≤ 25 for healthy body weight participants
- No known infertility
- No known risk factors for tubal disease
Exclusion Criteria:
- Significant medical co-morbidities (e.g. heart, kidney, liver, autoimmune disease)
- Significant anemia
- Cancer other than minor skin cancers
- Conditions that would complicate pregnancy
- Recent use of anti-obesity drugs or appetite suppressants
- Previous bariatric surgery
- Endometriosis AFS (American Fertility Society classification class III or IV)
- Progesterone > 10 IU/ml
- Current pregnancy
- Use of sperm donor
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Obese - Very low energy diet (VLED)
Participants will adopt a very-low energy diet
|
Structured, intensive dietary intervention using liquid meal replacements aimed at providing 800 kcal/day with a weight loss goal of 15% from baseline
|
|
Active Comparator: Obese - Standard of care (SOC)
Participants will receive the standard of care for obese dietary education and advice to incorporate a low-calorie food based diet
|
Standard consultation with registered dietitian to determine appropriate caloric deficit for a low calorie diet, education and advice to achieve weight loss in obese women.
Standard of care for normal weight women
|
|
No Intervention: LEAN
Healthy weight women followed in parallel.
No dietary intervention prior to conceiving.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Preconception Weight Loss
Time Frame: Baseline to conception (up to 68 weeks post enrollment)
|
Primary pre-specified outcome is BMI change (kg/m2) after dietary intervention.
Trained staff will measure height and weight to the nearest .1cm
and .1kg
using a wall-mounted, precision stadiometer and calibrated digital scale.
BMI will be calculated (kg/m2).
|
Baseline to conception (up to 68 weeks post enrollment)
|
|
Maternal Diagnosis
Time Frame: Throughout pregnancy (up to 108 weeks post enrollment)
|
Gestational diabetes or hypertensive disorders in pregnancy
|
Throughout pregnancy (up to 108 weeks post enrollment)
|
|
Offspring Body Fat Mass
Time Frame: Delivery (up to 108 weeks post enrollment)
|
Percentage body fat (adiposity) in the offspring of women randomized to Very Low Energy Diet (VLED) compared to those randomized to Standard of Care (SOC).
Body composition will be assessed by PeaPod (fat mass in grams).
|
Delivery (up to 108 weeks post enrollment)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Fetal Growth Will be Assessed by Ultrasound
Time Frame: 2nd trimester (up to 90 weeks post enrollment) and 3rd trimester (up to 102 weeks post enrollment) of pregnancy
|
Abdominal circumference (cm) will be assessed through ultrasound to determine fetal growth.
|
2nd trimester (up to 90 weeks post enrollment) and 3rd trimester (up to 102 weeks post enrollment) of pregnancy
|
|
Ponderal Index
Time Frame: Delivery (up to 108 weeks post enrollment) up to 12 month post delivery follow-up (up to 160 weeks post enrollment)
|
Trained staff will measure infant length and weight to the nearest .1cm and .1kg using an infant length board and digital infant scale. Ponderal index will be calculated and used to assess growth from baseline to 12 months post birth. Ponderal index is weight/length (grams/cubic centimeters). |
Delivery (up to 108 weeks post enrollment) up to 12 month post delivery follow-up (up to 160 weeks post enrollment)
|
|
Mode of Delivery
Time Frame: Delivery (up to 108 weeks post enrollment)
|
Categorical as caesarean or vaginal delivery
|
Delivery (up to 108 weeks post enrollment)
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intrauterine Abnormalities
Time Frame: Throughout pregnancy
|
Categorical as miscarriage, intrauterine growth restriction (IUGR), fetal demise, fetal anomalies
|
Throughout pregnancy
|
|
Metabolome
Time Frame: Delivery
|
Multivariate computational models will assess the association of maternal and neonate metabolite to fetal growth and newborn weight (g) and adiposity (g).
|
Delivery
|
|
Cord Blood Related to Neonate Outcomes
Time Frame: Delivery
|
The maternal metabolome (~metabolites) will be related to neonate adiposity, gestational weight gain, pregnancy complications, and intrauterine fetal growth rate.
|
Delivery
|
|
Epigenetic Marks
Time Frame: Delivery
|
Differences in site-specific DNA methylation (~450,000 sites) in offspring cord blood mononuclear cells between the Standard of Care (SOC), Very Low Energy Diet (VLED) and lean groups will be assessed.
|
Delivery
|
|
Health-related Quality-of-life and Other Behavioral Assessments
Time Frame: Baseline, 12 month follow-up
|
Health-related quality-of-life and other behavioral assessments based on validated survey instruments
|
Baseline, 12 month follow-up
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Amy Rothberg, MD, University of Michigan
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nutrition Disorders
- Overnutrition
- Body Weight
- Overweight
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Obesity
- Health Services Administration
- Health Care Quality, Access, and Evaluation
- Quality of Health Care
- Quality Indicators, Health Care
- Standard of Care
Other Study ID Numbers
Other Study ID Numbers
- HUM00124673
- 1R01DK124862 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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