Background/Objective

Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy.

Subjects/Methods

This was a double-blind, randomized controlled trial. We recruited pregnant women with a body mass index (BMI) ≥ 30 kg/m² at their initial prenatal visit ( < 13 weeks gestation) and collected blood and urine samples at baseline, 24–28 weeks, and 32–36 weeks to measure micronutrient concentrations (vitamin C, E, B₆ and folate), markers of inflammation (C-reactive protein, interleukin-6, 8, and 1β) and oxidative stress (8-epi-PGF2α and malondialdehyde). We collected maternal and infant health data from enrollment to delivery as secondary outcomes. We enrolled 128 participants (64 in each arm), and 98 (49 in each arm) completed follow-up through delivery.

Intervention

Both groups received a standard prenatal vitamin containing the recommended daily allowance of micronutrients in pregnancy. In addition, the intervention group received a supplement with 90 mg vitamin C, 30 αTU vitamin E, 18 mg vitamin B₆, and 800 μg folic acid, and the control group received a placebo.

Results

The intervention group had higher vit B₆ (log transformed (ln), β 24–28 weeks: 0.76 nmol/L (95% CI: 0.40, 1.12); β 32–36 weeks: 0.52 nmol/L (95% CI: 0.17, 0.88)) than the control group. Vitamins C, E, erythrocyte RBC folate concentrations did not differ by randomization group. The intervention did not impact biomarkers of inflammation or oxidative stress. There were no differences in maternal or neonatal clinical outcomes by randomization group.

Conclusions

Higher concentrations of antioxidant vitamins during pregnancy increased specific micronutrients and did not impact maternal inflammation and oxidative stress, which may be related to dosing or type of supplementation provided.

Clinical trial registration

Clinical Trial Identification Number: NCT02802566; URL of the Registration Site: www.clinicaltrials.gov.

中文翻译：

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肥胖孕妇补充抗氧化微量营养素：一项随机对照试验

背景/目标

肥胖会增加孕产妇发病率并对儿童健康产生不利影响。母体炎症可能在不良后果中发挥作用。本研究的目的是确定向肥胖孕妇提供更高剂量的抗氧化微量营养素是否会提高关键抗氧化维生素的浓度并影响怀孕期间的炎症和氧化应激。

主题/方法

这是一项双盲、随机对照试验。我们招募了初次产前检查（妊娠<13周）时体重指数（BMI）≥30 kg/m ²的孕妇，并在基线、24-28周和32-36周时收集血液和尿液样本进行测量微量营养素浓度（维生素 C、E、B ₆和叶酸）、炎症标志物（C 反应蛋白、白细胞介素 6、8 和 1β）和氧化应激（8-epi-PGF2α 和丙二醛）。我们收集了从入组到分娩的母婴健康数据作为次要结果。我们招募了 128 名参与者（每组 64 名），其中 98 名参与者（每组 49 名）完成了分娩后的随访。

干涉

两组均接受标准产前维生素，其中含有孕期建议的每日微量营养素摄入量。此外，干预组补充90 mg维生素C、30 αTU维生素E、18 mg维生素B ₆和800 μg叶酸，对照组服用安慰剂。

结果

干预组具有较高的维生素B ₆（对数转换（ln），β 24-28周：0.76 nmol/L（95% CI：0.40，1.12）；β 32-36周：0.52 nmol/L（95% CI：比对照组高 0.17, 0.88))。维生素 C、E、红细胞 RBC 叶酸浓度在随机分组中没有差异。该干预措施不会影响炎症或氧化应激的生物标志物。随机分组的孕产妇或新生儿临床结果没有差异。

结论

怀孕期间较高浓度的抗氧化维生素会增加特定的微量营养素，并且不会影响母体炎症和氧化应激，这可能与所提供的补充剂的剂量或类型有关。

临床试验注册

临床试验识别号：NCT02802566；注册网站的 URL：www.clinicaltrials.gov。