An offpspring's health starts before conception and results of the NiPPeR randomized trial

Abstract

Improved maternal nutritional status is hypothesized to promote good pregnancy and infant health outcomes but trial evidence supporting the commencement of nutritional supplementation before conception is sparse. The NiPPeR (Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health) multinational double-blind randomized controlled trial conducted in United Kingdom, Singapore and New Zealand tested a nutritional formulation containing myo-inositol, probiotics and multiple micronutrients (intervention), compared with a standard micronutrient supplement (control), taken preconception and throughout pregnancy. The primary outcome of gestational glycemia at 28 weeks’ gestation showed no difference. However, differences in several pre-specified secondary outcomes were notable. The intervention reduced the incidence of preterm delivery particularly those associated with preterm pre-labor rupture of membranes, operative delivery for delayed second stage and major postpartum hemorrhage. It may also shorten time-to-conception in overweight women, to that similar to non-overweight/obese women. Importantly, the intervention associated with a reduction in the incidence of rapid infant weight gain and high body mass index at 2 years among offspring. Such evidence indicate the potential for preconception maternal nutritional interventions to have appreciable impact in shaping the long-term health of an individual and building resilience against non-communicable chronic diseases in the future.

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ORCID for Keith Godfrey: orcid.org/0000-0002-4643-0618

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