The overall purpose of the study is to answer the questions: Are early pregnancy micronutrient levels and other maternal metabolic parameters “predictive” of gestational diabetes (GDM) and adverse outcomes for mother and baby? If so, what are the mechanisms underlying this?
Of late, there has been plenty of interest in the academic field in identifying factors associated with ‘intrauterine programming’ of diabetes and metabolic risk factors for both mother and baby. The nutritional environment which a foetus is exposed to may, via epigenetic modifications, contribute to insulin resistance, high blood pressure and obesity in childhood and T2DM and cardiovascular disorders in later life.
We know from studies done in India that low Vitamin B12 levels in pregnancy, especially if combined with normal-high folate levels is associated with higher risk of GDM, type 2 diabetes (T2D) after pregnancy and higher adiposity (higher body fat content) and insulin resistance of the offspring. However, we are not sure if similar associations exist within a UK population. If the findings can be replicated via the PRiDE study, it could have huge public health importance as this could be one of the ways of reducing the incidence of metabolic disorders such as diabetes and cardiovascular disease in the next generation.
A team of researchers from University of Warwick, University of Southampton and KEM hospital, Pune, India has been involved in the preparation this study for the past 18 months to secure the funding. The scientific basis of this study was extensively reviewed by the Medical Research Council and Indian Council for Medical Research prior to being awarded this grant (ICMR-MRC Joint Initiative: Chronic Non-Communicable Diseases Research funding stream).
This will be the first large scale study of this nature to be conducted in the UK. This will be a case-control study designed to compare early pregnancy B12, folate and homocysteine levels in pregnant women who develop GDM (cases) and those who do not (controls). Additional factors will be studied about the mothers such as differences in dietary habits, socio-economic status, ethnic variations and the psychological impact of GDM. If any associations are found, we will go on to look for genetic and biochemical mechanisms for this from the blood, placental and umbilical tissues donated by the mothers to investigate further whether these associations are causal.