Impact of preconception and antenatal supplementation with myo-inositol, probiotics, and micronutrients on offspring BMI and weight gain over the first 2 years

• Published in: BMC medicine Vol. 22; no. 1; pp. 39 - 13
• Main Authors: Lyons-Reid, Jaz, Derraik, José G B, Kenealy, Timothy, Albert, Benjamin B, Ramos Nieves, J Manuel, Monnard, Cathriona R, Titcombe, Phil, Nield, Heidi, Barton, Sheila J, El-Heis, Sarah, Tham, Elizabeth, Godfrey, Keith M, Chan, Shiao-Yng, Cutfield, Wayne S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.01.2024; BioMed Central; BMC
• Subjects: Birth; Birth weight; Births; Body Mass Index; Body weight; Body-Weight Trajectory; Diabetes; Dietary Supplements; Female; Food and nutrition; Gestational age; Health aspects; Health promotion; Humans; Infant weight gain; Inositol; Inositols; Intervention; Micronutrients; Nutritional supplementation; Obesity; Offspring; Preconception; Pregnancy; Pregnant women; Prenatal care; Probiotics; Randomised trial; Research ethics; Risk management; Risk reduction; Sex; Vitamin deficiency; Weight; Weight Gain; Womens health; New Zealand; United Kingdom > UK; Singapore; Pregnancy; Infant weight gain; Preconception; Nutritional supplementation; Randomised trial
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-024-03246-w

Nutritional intervention preconception and throughout pregnancy has been proposed as an approach to promoting healthy postnatal weight gain in the offspring but few randomised trials have examined this. Measurements of weight and length were obtained at multiple time points from birth to 2 years among 576 offspring of women randomised to receive preconception and antenatally either a supplement containing myo-inositol, probiotics, and additional micronutrients (intervention) or a standard micronutrient supplement (control). We examined the influence on age- and sex-standardised BMI at 2 years (WHO standards, adjusting for study site, sex, maternal parity, smoking and pre-pregnancy BMI, and gestational age), together with the change in weight, length, BMI from birth, and weight gain trajectories using latent class growth analysis. At 2 years, there was a trend towards lower mean BMI among intervention offspring (adjusted mean difference [aMD] - 0.14 SD [95% CI 0.30, 0.02], p = 0.09), and fewer had a BMI > 95th percentile (i.e. > 1.65 SD, 9.2% vs 18.0%, adjusted risk ratio [aRR] 0.51 [95% CI 0.31, 0.82], p = 0.006). Longitudinal data revealed that intervention offspring had a 24% reduced risk of experiencing rapid weight gain > 0.67 SD in the first year of life (21.9% vs 31.1%, aRR 0.76 [95% CI 0.58, 1.00], p = 0.047). The risk was likewise decreased for sustained weight gain > 1.34 SD in the first 2 years of life (7.7% vs 17.1%, aRR 0.55 [95% CI 0.34, 0.88], p = 0.014). From five weight gain trajectories identified, there were more intervention offspring in the "normal" weight gain trajectory characterised by stable weight SDS around 0 SD from birth to 2 years (38.8% vs 30.1%, RR 1.29 [95% CI 1.03, 1.62], p = 0.029). Supplementation with myo-inositol, probiotics, and additional micronutrients preconception and in pregnancy reduced the incidence of rapid weight gain and obesity at 2 years among offspring. Previous reports suggest these effects will likely translate to health benefits, but longer-term follow-up is needed to evaluate this. ClinicalTrials.gov, NCT02509988 (Universal Trial Number U1111-1171-8056). Registered on 16 July 2015.