Preconceptional parental health, pregnancy health, and early baby environment all play important roles in the lifetime health of the kid and later adult.
These variables are investigated in ‘BABY1000,’ a pilot project designed to test a study design and uncover factors that function throughout three time periods to impact an individual’s future health.
The study’s findings were published in the British Medical Journal.
Introduction
According to the developmental hypothesis, variables active throughout the first 1,000 days of life, beginning at conception and lasting until the child’s second birthday, influence health and illness risk throughout an individual’s lifespan and that of subsequent generations.
These include environmental variables that influence epigenetic genome alteration.
Obesity, for example, appears to follow the same recurrent pattern over generations. Obesity is becoming more common all around the world. As a result, many more children are being exposed to high nutritional availability in utero, fuelling the next generation’s obesity.
If this pattern is to be interrupted, treatments that begin before conception are required. Other variables that have an impact on the child’s long-term health include the mother’s preconception weight, physical activity, weight increase throughout pregnancy, stress, mental health, smoking, gestational diabetes, and the mother’s gut microbiota.
There is little understanding of how and when these variables function, or how they might be reduced. The current study is one of numerous that are attempting to find related health variables and results. Unlike other birth cohort studies, this one began collecting data before conception, extending the scope of the study.
This research focuses on obesity as an intergenerational problem. The study was designed as a prospective pilot study to test the project’s viability and acceptability.
Participants in the research were all Sydney residents who enrolled before or after 12 weeks of pregnancy. All participants were followed up on until postpartum, and children were followed up on until they were two years old.
What did the study reveal?
The investigation is still underway. The current findings contain participant demographic and nutritional data at baseline, as well as a full description of how the study questions were developed and modified.
Some of the research questions that were eventually determined to be of high priority include whether early weight loss intervention, either before or between pregnancies, improves outcomes for the offspring of mothers with excess body mass; the best interventions to alleviate the negative effects of overweight and obesity for both mothers and infants; how maternal dietary practices affect the cardiovascular and metabolic health of the offspring; and the best pre conceptional diet p
Questions on breastfeeding strategies, infant gut microbiome with breast- vs. formula- or combined feeding, socioeconomic influences on maternal and baby health during and after pregnancy, influences on diet choice in pregnancy, the role of social support groups, and the effect of insulin resistance before conception on glucose intolerance in and after pregnancy, as well as on the offspring were also included.
The study questions were finalized in three steps. First, possible questions were acquired through semi-structured interviews with field scientists and health experts. This resulted in 134 questions encompassing the three periods of life: preconception, pregnancy, and early childhood.
A workshop was then planned, with three groups representing the three periods of life. Each group examined the questions pertaining to the four life stages, adding their own, if any. The most pertinent questions were presented to the panel for consideration.
An online survey of all original attendees and those interested in this subject was used to make judgments on the final 15 questions. The GRADE standards (Grading of Recommendations, Assessment, Development, and Evaluation) were used to rate these issues.
All participants were 18 or older and hoped to have a child within 6-12 months, however, the majority (211/225) were pregnant within the first 13 weeks. Most went to a clinic at Sydney’s Royal Prince Alfred Hospital (RPAH) and planned to give birth there. This is one of the city’s major public teaching hospitals.
A few ladies came from different hospitals but were ready to share their information with the researchers.
The recruitment process began in December 2017 and was scheduled to go through August 2020. Due to the advent of the pandemic, recruiting was halted sooner than projected, restricting the sample size to 225 rather than the planned 250.
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Furthermore, follow-up was hampered by public health limits on research implemented as part of pandemic preparedness procedures. This had an unavoidable impact on the study’s completion.
Of the 225 participants, 180 were still enrolled in the research at the time of delivery, and 120 had completed a questionnaire six weeks later. The average age was 33 years, which was slightly older than the national and state averages of 31 years. Half of the mothers were expecting their first child.
Half were born in Australia, and 55% were European, with 31% being Southern, Eastern, or Southeast Asian. Despite accounting for 5% of the pregnant population nationally and in each state, no indigenous Australians took part.
In comparison, 37% of RPAH-delivering women, or 42% in NSW were overweight or obese.
According to Australian standards, pre-conceptional dietary quality was poor. Before and during pregnancy, nearly seven out of every eight women consumed too much-saturated fat.
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Micronutrient consumption from food was inadequate, with virtually all women obtaining insufficient iron from their diet. Approximately 80% did not fulfill dietary needs for iodine or calcium, both of which are essential for the baby’s thyroid and bone metabolism, and approximately half did not obtain enough dietary folate without supplements.
