- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00634764
Predictors of Maternal Weight Gain and Neonatal Body Composition
Resting Metabolic Rate, Insulin Resistance, and Attitude Towards Weight Gain During Pregnancy to Predict Maternal Weight Gain and Neonatal Body Composition.
Obesity is a significant health issue in the United States with 30% of the US population considered obese defined as a body mass index above 30 kg/m2. Obesity is associated with long term health complications including diabetes and cardiovascular disorders. During pregnancy, obesity is associated with an increased risk of fetal macrosomia and birth injury, as well as increased risk of gestational diabetes, preeclampsia, cesarean birth, and preterm birth. The intrauterine environment has been purported to influence the early childhood and lifelong risk of obesity and the metabolic syndrome (obesity, hyperlipidemia, and insulin resistance [IR]). The Institute of Medicine guidelines for maternal weight gain in pregnancy provide an estimate for population goals, but may be inadequate for individual patient needs. Other factors, such as the degree of maternal IR and resting metabolic rate (RMR) may be more predictive of actual nutritional needs during pregnancy. A better determination of caloric and exercise needs may allow the development of more specific dietary recommendations during pregnancy. Optimal nutrition will result in improved maternal and neonatal outcomes. As the intrauterine environment may have important impacts on neonatal and childhood metabolic and cardiovascular outcomes, creation of a favorable intrauterine environment through optimal maternal nutritional and exercise guidelines may reduce well documented problems such as fetal macrosomia, birth injury, cesarean delivery, and later predisposition toward childhood obesity.
The goal of this pilot trial therefore is to correlate maternal resting metabolic rate, dietary characteristics, and insulin resistance levels with fetal birth weight and body composition in an effort to determine which factors are associated with excessive fat mass in the neonate, placing them at increased lifetime risk of obesity.
We hypothesize that women with lower resting metabolic rates (RMR) in the first trimester will demonstrate a greater maternal weight gain, when adjusted for caloric intake and activity. It is also hypothesized that for a given RMR, the degree of maternal insulin resistance (IR) predicts birthweight adjusted for a given caloric intake. A third hypothesis is that women with increased insulin resistance (measured by HOMA) will result in neonates with larger birth weights and a greater degree of neonatal fat mass as measure by DEXA scan, adjusted for RMR and diet characteristics.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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South Carolina
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Charleston, South Carolina, United States, 29425
- Medical University of South Carolina
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Women must be obtaining prenatal care at Cannon Place clinic or at the Prenatal Wellness Center
- Enrolled for prenatal care at less than 16 weeks gestational age
- Singleton pregnancy without fetal abnormalities
- Ability to provide informed consent
- Subjects must complete prenatal visits when data will be collected, and be willing and able to attend three GCRC study visits
- Maternal age >18 and <45
- Neonate born to mother enrolled in trial
Exclusion Criteria:
- Subjects with diabetes, hypertension, prior preterm birth, chronic respiratory disease (asthma on daily medication, COPD, cystic fibrosis) or maternal cardiac disease
- Subjects currently taking insulin sensitizing medications (metformin)
- Subject unable to perform MedGem procedure
- Neonates delivered prior to 34 weeks gestational age will be excluded from analysis by the DEXA scan
- Neonates with fetal anomalies diagnoses in the antenatal period or postpartum will not be included in the study
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Pregnant
Pregnant women who present to MUSC's Cannon Place or Prenatal Wellness Center
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
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Maternal weight gain, resting metabolic rate (kcal/day)
Time Frame: During gestation
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During gestation
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Neonatal birth weight (gram), ponderal index
Time Frame: After birth
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After birth
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Maternal diet composition, exercise evaluation, insulin resistance, weight gain attitude
Time Frame: During gestation
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During gestation
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Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Donna Johnson, Medical University of South Carolina, Obstetrics-Gynecology
- Principal Investigator: William Goodnight, MD, Medical University of South Carolina
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- HR # 16751
- GCR Protocol # 769
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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