NCT04937348

Brief Summary

Diabetes mellitus is one of the most common metabolic disorders complicating the course of pregnancy, which concerns pre-pregnancy diabetes (PGDM) - most often type 1 or type 2; and gestational diabetes (GDM) - treated with diet (G1) or insulin (G2). Currently, in the pathogenesis of diabetes and the regulation of glucose metabolism, the role of tissue hormones, including adipokines, e.g., omentin-1, visfatin, have been considered. Adipokines might also affect the development of the fetus - mainly fetal adipose tissue gain. Their concentrations and activity depend on the maternal visceral fat content and concomitant metabolic disorders. It is known that adipokines are excreted in human milk during the lactation period. The aim of the study was to assess the impact of diabetes during pregnancy, requiring treatment with diet or insulin, on the nutritional status of the newborn.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
70

participants targeted

Target at P25-P50 for all trials

Timeline
Completed

Started Dec 2019

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 13, 2019

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 5, 2021

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

March 17, 2021

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

June 11, 2021

Completed
13 days until next milestone

First Posted

Study publicly available on registry

June 24, 2021

Completed
Last Updated

June 24, 2021

Status Verified

May 1, 2021

Enrollment Period

1.2 years

First QC Date

June 11, 2021

Last Update Submit

June 21, 2021

Conditions

Keywords

gestational diabetesadipokinesvisfatinomentinnutritional statusneonatebreast milk

Outcome Measures

Primary Outcomes (3)

  • Fat body mass [kg]

    Changes in infantile fat body mass between 2 timepoints (the first week of life and the 2nd visit).

    up to 6 months

  • Total body water [l]

    Changes in infantile total body water between 2 timepoints (the first week of life and the 2nd visit).

    up to 6 months

  • Anthropometrics: body weight [kg], length [cm], head circumference [cm].

    Changes in infantile anthropometrics between 2 timepoints (the first week of life and the 2nd visit). On the basis of weight and length, BMI (kg/m2) and Ponderal Index will be calculated (kg/m3).

    up to 6 months

Secondary Outcomes (4)

  • Breast milk composition

    up to 6 months

  • Adipokines

    up to 6 months

  • Impact of maternal adipokines on infantile body fat mass.

    up to 6 months

  • Impact of maternal adipokines on breast milk composition.

    up to 6 months

Study Arms (3)

GDM G1

Mothers diagnosed with gestational diabetes mellitus, treated with diet; and their newborns

Diagnostic Test: Acquisition and analysis of milk samplesDiagnostic Test: Collection, preparation and analysis of mother's blood samples.Diagnostic Test: Body composition assessmentOther: Anthropometric measurements

GDM G2

Mothers diagnosed with gestational diabetes mellitus, treated with insulin; and their newborns

Diagnostic Test: Acquisition and analysis of milk samplesDiagnostic Test: Collection, preparation and analysis of mother's blood samples.Diagnostic Test: Body composition assessmentOther: Anthropometric measurements

non-GDM / control group

Healthy, non-diabetic mothers, without disturbances in glucose metabolism; and their newborns. Control group.

Diagnostic Test: Acquisition and analysis of milk samplesDiagnostic Test: Collection, preparation and analysis of mother's blood samples.Diagnostic Test: Body composition assessmentOther: Anthropometric measurements

Interventions

In order to ensure reproducible results, breast milk samples were collected using a breast pump. Samples were taken in the morning, after the newborn was breastfed. The entire breast was emptied. In order to ensure the stability of the microbiological and nutritional composition, the milk samples were cooled immediately after collection, and then divided into test tubes and frozen (-80 C) until the laboratory tests were made. The concentrations of macronutrients (protein, fat, carbohydrate) in breast milk were determined using a Human Milk Analyzer (HMA; Miris, Uppsala). Tissue hormones, e.g. adipokines: visfatin, omentin-1 were determined by ELISA method using commercial reagent kits.

GDM G1GDM G2non-GDM / control group

Blood samples were collected from the mothers (fasting if possible) on the day the milk samples were taken. After collection, fasting glucose and insulin, as well as glycated hemoglobin were marked, and the other samples were centrifuged and frozen until analyzed (-80 C). Determination of adipokines was performed by ELISA method, using commercial reagent kits.

GDM G1GDM G2non-GDM / control group

The body composition of newborns was determined by a non-invasive electrical bioimpedance method using the body composition analyzer.

GDM G1GDM G2non-GDM / control group

Based on the mother's medical records, maternal height and pregnancy weight changes were recorded. On the day the biological material is collected, the mother was weighed. From the baby's documentation, measurements of the length, head circumference and body weight taken after delivery and during the hospitalization were recorded. These measurements were repeated on the days of the body composition analysis.

GDM G1GDM G2non-GDM / control group

Eligibility Criteria

Age18 Years - 45 Years
Sexfemale
Healthy VolunteersYes
Age GroupsAdult (18-64)
Sampling MethodNon-Probability Sample
Study Population

The study group included mothers with diagnosed diabetes and their newborns. Women with gestational diabetes, both treated with diet and treated with insulin - each group was supposed to include at least 20 patients. Additionally, if possible, women diagnosed with type 1 and type 2 pre-pregnancy diabetes or insulin resistance might have been included in the study. The control group consisted of 20 healthy women and their newborns.

You may qualify if:

  • mother's age 18 - 45 years;
  • delivery at term (≥ 37 + 0/7 weeks of pregnancy) or close to the delivery date (from 35 + 0/7 to 36 + 6/7 weeks of pregnancy), both by vaginal delivery and by caesarean section;
  • single pregnancy;
  • good condition of the child after birth, rated \> 7 points on the Apgar score after the 1 st minute of life;
  • feeding the baby only naturally (with breast or expressed breast milk) or mainly naturally;
  • mother's informed and voluntary consent to participate in the study;
  • mother's informed and voluntary consent to the participation of her child in the study.

You may not qualify if:

  • mother's lack of consent to participate in the study;
  • mother's lack of consent to the participation of her child in the study;
  • mother's age \<18 years and \> 45 years;
  • preterm labor \<35 + 0/7 weeks of pregnancy;
  • multiple pregnancy;
  • the child's condition at birth is moderate or severe, rated at ≤ 7 points on the Apgar score after the 1st minute of life;
  • feeding a child exclusively or mainly with an infant formula;
  • severe birth defects of a newborn,
  • any clinical condition of the mother and / or the newborn that may affect the nutritional status of the newborn (IUGR, lack of medical care during pregnancy, addiction of the mother to alcohol or other psychoactive substances, nicotinism in pregnancy, uncontrolled asthma in the mother, metabolic diseases in the mother or newborn).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department and Clinic of Neonatology, Jan Mikulicz-Radecki University Teaching Hospital, Wroclaw Medical University

Wroclaw, Lower Silesian Voivodeship, 50-556, Poland

Location

Biospecimen

Retention: SAMPLES WITHOUT DNA

serum, breast milk

MeSH Terms

Conditions

Diabetes, GestationalDiabetes Mellitus

Condition Hierarchy (Ancestors)

Pregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

June 11, 2021

First Posted

June 24, 2021

Study Start

December 13, 2019

Primary Completion

February 5, 2021

Study Completion

March 17, 2021

Last Updated

June 24, 2021

Record last verified: 2021-05

Data Sharing

IPD Sharing
Will not share

Locations