We have found that, compared with the control nutritional drink, the enriched nutritional drink did not affect the mother鈥檚 blood sugar levels during pregnancy. However, it did substantially reduce the likelihood of the baby being born preterm and the risk of major blood loss during delivery.
More recently, we reported that the enriched drink was also associated with a shorter duration of the 鈥減ushing鈥 second stage of delivery. It also reduced the need for deliveries by forceps/ventouse or caesarean section for a delayed second stage of labour. The overall time taken to become pregnant was similar in the groups taking the control and enriched drinks, but mothers with body weight in the overweight category did conceive more quickly if taking the enriched drink.
Important recent observations have shown that the children of mothers taking the enriched drink had a reduced likelihood of excessive weight gain between birth and age 2 years, and a lower prevalence of child obesity at age 2 years.
Collectively, these are exciting and important findings. We have identified potential new ways to:
- prevent preterm delivery.
- lessen the risk of major blood loss during delivery.
- reduce the risk of excessive early infant weight gain and child obesity.
We are continuing to analyse the data and samples collected in the study. This is a selection of our findings and publications so far:
In this paper reporting the primary outcome of the study, we did not find the mother鈥檚 blood sugar levels or birthweights of the 585 babies born were influenced by the enriched drink. We did, however, find a substantial decrease in the incidence of preterm birth, particularly the cases associated with preterm pre-labour rupture of membranes. This provides the first evidence that a nutritional supplement taken before and during pregnancy can help prevent preterm delivery.
Godfrey KM et al., Diabetes Care, Vol 44 (2021)
We have followed up our original findings that the NiPPeR intervention more than halved the chance of the baby being born prematurely, with information that the amount of blood lost during delivery is reduced. Even more so we have found that the duration of the 鈥減ushing phase鈥 of labour was shorter in the mums who had taken the enriched drink.
Chan SY et al., American Journal of Obstetrics & Gynecology, Maternal and Fetal Medicine, Vol 4, Issue 6 (2022)
Recently we published findings that the enriched NiPPeR drink did not overall shorten the time it took couples to conceive. However, there was evidence that those with body weight in the overweight category conceived faster if they were taking the enriched drink.
Chan SY et al., Fertility and Sterility, Vol 119, Issue 6 (2023)
In the NiPPeR study many mothers provided samples of their breast milk, in which the levels of zinc were measured. Zinc is thought to be important for a baby鈥檚 growth and immune system development. Additional zinc was provided in the NiPPeR enriched drink, and the measurements showed this increased the amounts of zinc in breast milk, even though the supplement was not continued after delivery. Other potential components in breast milk are currently being studied.
Han SM et al., Frontiers in Nutrition, Vol 9 (2023)
Some gut bacteria are shared between mothers and their infants, but our study showed that the bacteria express different genes in the mother and infant. We are now working on more detailed studies of the gut bacteria in all of the NiPPeR mothers, which will be followed by the study of gut bacteria in the stool samples from the babies!
Vatanen T et al., Scientific Reports, Vol 12 (2022)
Preliminary findings suggest that the NiPPeR intervention might have important benefits to lower the chance of a child becoming overweight. The analyses indicated that infants whose mothers took the intervention supplement before and during pregnancy were less likely to have high weight gain after birth and a lower risk of obesity at age 2 years.
Lyons-Reid J et al., BMC Medicine, Vol 22 (2024)
Analyses of the information on foods eaten during the preconception period allowed us to identify three combinations of foods, drinks, and nutrients that people typically consume. These 鈥渄ietary patterns鈥 can influence the mother鈥檚 nutritional status and showed some consistent features across the study sites.
Lim SX et al., Current Developments in Nutrition, Vol 4, Supplement 2 (2020)
Internationally, there are few studies describing the usual diets of women attempting to become pregnant. Our findings from the NiPPeR questionnaires have filled this important gap, describing 3 common patterns of diet, typified by a) vegetables, fruits and wholegrain bread, b) processed meat, confectionery and sweetened beverages and c) fish, poultry, noodles and rice.
Lim SX et al., Current Developments in Nutrition, Vol 6, Issue 7 (2022)Our studies of child body composition and growth using the DXA scans of the babies and young children in New Zealand and using the PeaPod and BIA devices in each of the 3 sites have helped us and researchers worldwide to measure the relative amounts of muscle, fat and bone. These amounts influence how the body handles our diet, and may impact the child鈥檚 later health, strength and physical abilities.
Lyons-Reid J et al., Scientific Reports, Vol 22 (2022)
Lyons-Reid J et al., Frontiers in Nutrition, Vol 9, (2022)
Lyons-Reid J et al., Scientific Reports, Vol 11 (2021)
Lyons-Reid J et al., European Journal of Clinical Nutrition, Vol 78, (2024)
Analyses of the mother鈥檚 vitamin status before, during and after pregnancy showed that nine out of ten women had marginal or low levels of folate, riboflavin, vitamins B12 or D around the time of conception, and that many developed vitamin B6 deficiency in late pregnancy.
Godfrey K M et al., PLOS Medicine, Vol 20, (2023)
Measurements of vitamin concentrations in samples of breast milk provided by NiPPeR participants showed that supplementation during preconception and pregnancy increased breast milk vitamin D concentrations, even though the supplementation stopped at delivery. Breast milk B-vitamin concentrations were not related to the prenatal supplementation.
Han SM et al., Clinical Nutrition, Vol 42, Issue 12 (2023)
Analyses of the energy and nutrient content of breast milk samples showed higher energy and fat levels in mothers with a higher body weight and in those who developed diabetes during pregnancy. The measurements will allow us to examine the potential for interventions during breastfeeding to support the child鈥檚 growth and development.
Han SM et al., Frontiers in Nutrition, Vol 10 (2023)
Analysis of the mother鈥檚 vitamin status has provided us with initial insights that myo-inositol may be important in bringing about a reduction in blood loss immediately after the delivery of the baby.
Chang HF et al., Nutrients, Vol 16 (2024)
Other studies have suggested that myo-inositol supplements in pregnancy may reduce some pregnancy complications. However, our study provides the first evidence that increasing plasma myo-inositol in the initial weeks of pregnancy may result in a very small increase in late pregnancy blood sugar levels among healthy women without this affecting pregnancy outcomes. This suggests further investigation is needed to identify the best timing for starting myo-inositol supplementation in pregnant women.
Chan SY et al., Diabetes, Obesity and Metabolism, Vol 26, Issue 5 (2024)
In this paper we analysed the questionnaire information on the mother鈥檚 mental wellbeing before, during and after pregnancy. Taking the enriched NiPPeR supplement during preconception and pregnancy had no effect on the mother鈥檚 mood and anxiety, but there was evidence of a modest improvement in mental health functioning from preconception to 6-months post-delivery.
El-Heis S et al., Psychiatry Research, Vol 334 (2024)