Effect of Obesity, Diabetes and Bariatric Surgery on Pregnancy Outcomes

NCT ID: NCT05753124

Last Updated: 2023-03-03

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

RECRUITING

Total Enrollment

700 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-05-31

Study Completion Date

2027-10-31

Brief Summary

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The obesity epidemic is growing worldwide and in the UK this is perpetuated with a third of women classified as overweight/obese in 2020. Many of these woman are of childbearing age and go on to have high risk pregnancies which are often complicated by gestational or pre-existing (type 2 diabetes mellitus (GDM, T2DM). Bariatric surgery is the most successful treatment of sustainable weight loss and is associated with a reduction in rates of GDM, pre-eclampsia, delivery of large babies but increased risk of delivery of small babies and preterm delivery.

The aims of the study are to investigate the maternal and fetal/neonatal, biophysical and biochemical, intra-uterine environment and postnatal profile of pregnancies:

1. affected by maternal obesity and/or GDM/T2DM compared to pregnancies with normal maternal body mass index (BMI).
2. with previous maternal bariatric surgery compared to pregnancies without previous bariatric surgery but matched for maternal pre-surgery and early pregnancy BMI.

Detailed Description

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This is an observational study. The investigators are planning to study pregnant women with normal BMI or overweight (BMI\<30), obesity (BMI ≥30) and glucose disorders (GDM and T2DM). The investigators will also study pregnant women with previous bariatric surgery (gastric band, sleeve gastrectomy or gastric bypass) and compare them with pregnant women of similar pre-surgery and early pregnancy BMI, but no hisotry of weight loss surgery.

For all the participants and serially during pregnancy (at 12-14, 20-24, 26-28, 30-32, 35-37 weeks gestation and postnatally (at 6 weeks, 3 months, 12-24 months and 3-7 years of age), the investigators will perform the following investigations:

Maternal investigations: Demographics and medical history will be recorded, weight, height, waist to hip ratio and blood pressure will be measured, blood, urine, stool samples and vaginal swabs will be obtained, cervical length (by trans-vaginal ultrasound) will be measured and maternal echocardiography will be performed. Maternal glucose homeostasis will be assessed at 26-28 weeks of gestation, by a full oral glucose tolerance test, HOMA, home glucose monitoring and/ or continuous glucose monitoring (CGM), depending on the group the women belong to.

Fetal investigations: Fetal growth and well being will be assessed by 2D, 3D and Doppler ultrasound, fetal echocardiography will be performed.

At and following delivery: Maternal blood and urine samples and subcutaneous and omental fat (if Caesarean section is performed) will be obtained, placental tissue will be stored. Neonatal cord blood will be obtained, birthweight (percentiles), anthropometric characteristics will be measured, meconium and urine samples will be obtained and neonatal MRI (to assess body fat distribution) will be arranged.

Postnatal follow up visits for the mother and the infant (at 6 weeks, 3 months, 12-24 months, 3-7 years old) will be arranged and maternal and infant blood and urine samples will be requested and obtained.

Conditions

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Obesity Pregnancy in Diabetic Pregnancy Complications Pregnancy Related Bariatric Surgery Status Complicating Pregnancy

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Pregnant women with obesity/GDM/T2DM

Pregnant women with obesity/GDM/T2DM

No interventions assigned to this group

Pregnant women with obesity/GDM/T2DM- Controls

Pregnant women with normal BMI/ no GDM orT2DM

No interventions assigned to this group

Post-bariatric pregnant women

Pregnant women with previous bariatric surgery

Observational

Intervention Type OTHER

This is an observational study

Pregnant no bariatric women- Controls

There will be two control groups of women with no previous bariatric surgery:

1\. Pregnant women with booking BMI similar to the booking BMI of the post-bariatric ones and 2. Pregnant women with booking BMI similar to the pre-surgery BMI of the post-bariatric ones.

No interventions assigned to this group

Interventions

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Observational

This is an observational study

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pregnant women with normal size (BMI \<30)
* Pregnant women with obesity (BMI ≥30)
* Pregnant women with glucose disorders
* Pregnant women with previous bariatric surgery

Exclusion Criteria

* Pregnant women less than 18 years of age
* Pregnant women with twins/triplets
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Chelsea and Westminster NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MAKRINA SAVVIDOU, MD

Role: PRINCIPAL_INVESTIGATOR

CHELSEA & WESTMINSTER HOSPITAL NHS FT

Locations

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Chelsea & Westminster Hospital Nhs Ft

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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DAMON FOSTER

Role: CONTACT

DORIS DABY

Role: CONTACT

Facility Contacts

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MAKRINA SAVVIDOU, MD

Role: primary

Other Identifiers

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142103

Identifier Type: -

Identifier Source: org_study_id

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