Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health

NCT ID: NCT02509988

Last Updated: 2023-05-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

1729 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2022-06-30

Brief Summary

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The study aims to assess whether a nutritional drink taken before conception and continuing through pregnancy, assists in the maintenance of healthy glucose metabolism in the mother and promotes offspring health.

Detailed Description

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It is known that maternal insulin resistance and high blood glucose levels in early pregnancy alter the functioning of the placenta in ways that persistently affect the supply of nutrients and fat in the unborn baby. There is an increasing focus on the need to optimise preconception nutrition but as yet, limited preconception interventions that are recognized as promoting health for the mother and her child.

The Investigators will recruit up to 1800 women, aged 18-38 years, who are planning a pregnancy in the United Kingdom, Singapore and New Zealand with the aim of securing 600 or more pregnancies. The participants will be randomly allocated to receive the standard nutritional drink or the study nutritional drink. Women who conceive between one and twelve months after starting the nutritional drink will be followed through pregnancy and studied with their babies for three years after delivery. Various testing will be carried out at relevant time points. Mothers will undergo blood, urine, hair and cheek swab sampling, dual-energy X-ray absorptiometry (DXA) scans along with body measurements and health and lifestyle questionnaires. Infants will undergo hair, cheek swab, urine and stool sampling along with body measurements, measurements of body composition and a DXA scan. Placental, cord and other perinatal tissues/samples will be collected.

The data collected will allow identification of the contributions of nutritional and lifestyle factors, social and economic status, ethnicity, genetics and metabolomics and gut microbes to maintaining healthy glucose metabolism in pregnancy, enhancing fertility, mood and reproductive outcomes in the mother, and promoting healthy growth, body composition and wellbeing in the children.

The effect of the intervention on the primary outcome will be examined in two special interest groups; i) women who are overweight or obese prior to conception \& ii) women with documented evidence of dysglycemia prior to conception.

Conditions

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Hyperglycemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Intervention (study nutritional drink)

Study nutritional drink comes in the form of a sachet to mix with water \& take twice a day (once in the morning and once in the evening).

The drink will be taken before the participant becomes pregnant (for up to 1 year) and throughout pregnancy.

Group Type EXPERIMENTAL

Study nutritional drink

Intervention Type DIETARY_SUPPLEMENT

Study nutritional drink containing a mix of micronutrients, probiotics and myo-inositol.

Control (standard nutritional drink)

Standard nutritional drink comes in the form of a sachet to mix with water \& take twice a day (once in the morning and once in the evening).

The drink will be taken before the participant becomes pregnant (for up to 1 year) and throughout pregnancy.

Group Type ACTIVE_COMPARATOR

Standard nutritional drink

Intervention Type DIETARY_SUPPLEMENT

Standard nutritional drink containing a mix of micronutrients.

Interventions

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Study nutritional drink

Study nutritional drink containing a mix of micronutrients, probiotics and myo-inositol.

Intervention Type DIETARY_SUPPLEMENT

Standard nutritional drink

Standard nutritional drink containing a mix of micronutrients.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Women aged 18-38 years
* Planning to conceive within 6 months
* Able to provide written, informed consent
* In Singapore: Chinese, Malay and Indian ethnicity or mixed Chinese/Malay/Indian ethnicity

Exclusion Criteria

* Pregnant or lactating at recruitment
* Assisted fertility, apart from those taking clomiphene or letrozole alone
* Pre-existing diabetes (type 1 or type 2)
* Oral or implanted contraception currently or in the last month, or with an Intrauterine Contraceptive Device (IUCD) in situ
* On metformin or systemic steroids currently or in the last month
* Known serious food allergy
* Not able to give informed consent
* Women on anticonvulsants (who are treated with high dose B vitamins in pregnancy) currently or in the last month
* On treatment for Human Immunodeficiency Virus (HIV), Hepatitis B or C currently or in the last month

The partners of the women (over 16 years of age) will also be invited to participate in the study. After having gained written informed consent, fathers will have blood, urine, hair sampling, cheek swabs and body measurements taken and will complete a health and a lifestyle questionnaire at one of the visits during pregnancy.

The mother will consent for their babies to have body measurements, buccal, hair, stool samples and allergy testing from birth to 3.5 years.
Minimum Eligible Age

18 Years

Maximum Eligible Age

38 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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National University Hospital, Singapore

OTHER

Sponsor Role collaborator

Auckland UniServices Ltd.

INDUSTRY

Sponsor Role collaborator

Institute for Human Development and Potential (IHDP), Singapore

OTHER

Sponsor Role collaborator

National University of Singapore

OTHER

Sponsor Role collaborator

Nestec Ltd.

INDUSTRY

Sponsor Role collaborator

University of Southampton

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wayne Cutfield, BHB MB ChB DCH MD FRACP

Role: PRINCIPAL_INVESTIGATOR

The University of Auckland

Shiao-Yng Chan, MBBChir (UK), FRCOG (UK), PhD

Role: PRINCIPAL_INVESTIGATOR

National University Hospital, Singapore

Keith Godfrey, BM PhD FRCP

Role: PRINCIPAL_INVESTIGATOR

MRC Lifecourse Epidemiology Unit, University of Southampton

Locations

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The University of Auckland

Auckland, , New Zealand

Site Status

National University Hospital

Singapore, , Singapore

Site Status

University Hospital Southampton NHS Foundation Trust

Southampton, Hampshire, United Kingdom

Site Status

Countries

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New Zealand Singapore United Kingdom

References

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Godfrey KM, Cutfield W, Chan SY, Baker PN, Chong YS; NiPPeR Study Group. Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health ("NiPPeR"): study protocol for a randomised controlled trial. Trials. 2017 Mar 20;18(1):131. doi: 10.1186/s13063-017-1875-x.

Reference Type BACKGROUND
PMID: 28320484 (View on PubMed)

Han SM, Huang F, Derraik JGB, Vickers MH, Devaraj S, Redeuil K, Campos-Gimenez E, Pang WW, Godfrey KM, Chan SY, Thakkar SK, Cutfield WS; NiPPeR Study Group. A nutritional supplement during preconception and pregnancy increases human milk vitamin D but not B-vitamin concentrations. Clin Nutr. 2023 Dec;42(12):2443-2456. doi: 10.1016/j.clnu.2023.09.009. Epub 2023 Oct 5.

Reference Type DERIVED
PMID: 38411017 (View on PubMed)

Lyons-Reid J, Derraik JGB, Kenealy T, Albert BB, Ramos Nieves JM, Monnard CR, Titcombe P, Nield H, Barton SJ, El-Heis S, Tham E, Godfrey KM, Chan SY, Cutfield WS; NiPPeR Study Group. Impact of preconception and antenatal supplementation with myo-inositol, probiotics, and micronutrients on offspring BMI and weight gain over the first 2 years. BMC Med. 2024 Jan 30;22(1):39. doi: 10.1186/s12916-024-03246-w.

Reference Type DERIVED
PMID: 38287349 (View on PubMed)

Godfrey KM, Titcombe P, El-Heis S, Albert BB, Tham EH, Barton SJ, Kenealy T, Chong MF, Nield H, Chong YS, Chan SY, Cutfield WS; NiPPeR Study Group. Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLoS Med. 2023 Dec 5;20(12):e1004260. doi: 10.1371/journal.pmed.1004260. eCollection 2023 Dec.

Reference Type DERIVED
PMID: 38051700 (View on PubMed)

Han SM, Derraik JGB, Vickers MH, Devaraj S, Huang F, Pang WW, Godfrey KM, Chan SY, Thakkar SK, Cutfield WS; NiPPeR Study Group. A nutritional supplement taken during preconception and pregnancy influences human milk macronutrients in women with overweight/obesity and gestational diabetes mellitus. Front Nutr. 2023 Oct 17;10:1282376. doi: 10.3389/fnut.2023.1282376. eCollection 2023.

Reference Type DERIVED
PMID: 37915619 (View on PubMed)

Lyons-Reid J, Derraik JGB, Kenealy T, Albert BB, Nieves JMR, Monnard CR, Titcombe P, Nield H, Barton SJ, El-Heis S, Tham E, Godfrey KM, Chan SY, Cutfield WS. The effect of a preconception and antenatal nutritional supplement on children's BMI and weight gain over the first 2 years of life: findings from the NiPPeR randomised controlled trial. Lancet Glob Health. 2023 Mar;11 Suppl 1:S11-S12. doi: 10.1016/S2214-109X(23)00095-5.

Reference Type DERIVED
PMID: 36866469 (View on PubMed)

Chan SY, Barton SJ, Loy SL, Chang HF, Titcombe P, Wong JT, Ebreo M, Ong J, Tan KM, Nield H, El-Heis S, Kenealy T, Chong YS, Baker PN, Cutfield WS, Godfrey KM; NiPPeR Study Group. Time-to-conception and clinical pregnancy rate with a myo-inositol, probiotics, and micronutrient supplement: secondary outcomes of the NiPPeR randomized trial. Fertil Steril. 2023 Jun;119(6):1031-1042. doi: 10.1016/j.fertnstert.2023.01.047. Epub 2023 Feb 6.

Reference Type DERIVED
PMID: 36754158 (View on PubMed)

Han SM, Devaraj S, Derraik JGB, Vickers MH, Huang F, Dubascoux S, Godfrey KM, Chan SY, Pang WW, Thakkar SK, Cutfield WS; NiPPeR Study Group. A nutritional supplement containing zinc during preconception and pregnancy increases human milk zinc concentrations. Front Nutr. 2023 Jan 10;9:1034828. doi: 10.3389/fnut.2022.1034828. eCollection 2022.

Reference Type DERIVED
PMID: 36704795 (View on PubMed)

Lim SX, Cox V, Rodrigues N, Colega MT, Barton SJ, Childs CE, Conlon CA, Wall CR, Cutfield WS, Chan SY, Godfrey KM, Chong MF; NiPPeR Study Group. Evaluation of Preconception Dietary Patterns in Women Enrolled in a Multisite Study. Curr Dev Nutr. 2022 Jun 25;6(7):nzac106. doi: 10.1093/cdn/nzac106. eCollection 2022 Jul.

Reference Type DERIVED
PMID: 36628060 (View on PubMed)

Godfrey KM, Barton SJ, El-Heis S, Kenealy T, Nield H, Baker PN, Chong YS, Cutfield W, Chan SY; NiPPeR Study Group. Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial. Diabetes Care. 2021 May;44(5):1091-1099. doi: 10.2337/dc20-2515. Epub 2021 Mar 29.

Reference Type DERIVED
PMID: 33782086 (View on PubMed)

Related Links

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Other Identifiers

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34104

Identifier Type: OTHER

Identifier Source: secondary_id

2015/00205

Identifier Type: OTHER

Identifier Source: secondary_id

U1111-1171-8056

Identifier Type: OTHER

Identifier Source: secondary_id

13597

Identifier Type: -

Identifier Source: org_study_id

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