Grant Abstract: BMI-Based Prenatal Vitamins To Ameliorate Oxidative Stress In Obese Pregnancy

Grant Number: 5K23HD074648-05
PI Name: Sarbattama
Project Title: BMI-Based Prenatal Vitamins To Ameliorate Oxidative Stress In Obese Pregnancy

Abstract: Obesity affects one in three pregnant women. Significantly, this is a trans-generational health issue. There is a link between the adverse intrauterine environment in obese pregnant women and the subsequent dysregulation of metabolism in the child. In the ongoing parent trial (K23HD074648, NCT02802566), we are recruiting obese (BMI=30kg/m2) pregnant women at =13 weeks gestation and randomizing them to either a standard prenatal vitamin (provided by the study) or a BMI-based prenatal vitamin (PNV) with higher concentrations of vitamins B6, C, E and folic acid. Our central hypothesis is that pregnancy in obese women creates an oxidant/anti-oxidant imbalance, which adversely impacts maternal health and neonatal outcomes. We hypothesize that restoring oxidant/anti-oxidant balance with a body mass index (BMI)-based prenatal micronutrient supplement will decrease inflammation and oxidative stress in obese pregnant women. The primary outcome of the parent study is maternal systemic concentrations of antioxidant micronutrients and markers of inflammation (C-reactive protein, CRP) and oxidative stress (8-OhdG and 8epiPGF2a.) To date, 88 subjects have completed the parent study and we anticipate a total sample size of 100 completed subjects by September, 2017. Supplemental funds are being requested to determine the effect of a BMI-based PNV on three additional biomarkers of inflammation (interleukin-6, interleukin-1ß and tumor necrosis factor a) and malonyldialdehyde, a highly sensitive secondary product of lipid peroxidation from serum at two points during pregnancy (before randomization and at 34-38 weeks of pregnancy.) In addition, we will investigate the impact of the BMI-based PNV on placental inflammation in obese women, using immunohistochemistry and real-time PCR to measure inflammatory protein and gene expression from archived placental samples in study subjects.

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