Mother and Child Health Program (MCH)
“Mother and Child Health Research Program in Bangladesh” which is a part of GIFTS “Genomic and lifestyle predictors of foetal outcome relevant to diabetes and obesity and their relevance to prevention strategies in South Asian peoples” study.
Diabetic Association of Bangladesh, Queen Mary University of London, University of Oslo and Mother & Child Health Training Institute, Azimpur, Dhaka
Funding Authority: European Union (FP7-HEALTH-2011)
Length of study program: 3 years
Phase: Phase 1 (WP2) and Phase 2 (WP4)
Overall objectives of this research program (WP2):
- To understand the early life determinants (genomic, lifestyle and environmental) of diabetes, obesity and related metabolic disease (the ‘cardiometabolic diseases’) in South Asians living in Europe and the countries from which they have emigrated that have given rise to variation in prevalence and incidence of disease.
- This research program will gather the distinctive prospective study from early pregnancy & explore potential hazards to women with low socioeconomic status.
- This study will also help to address both important public health problems and mechanism of disease.
- Phase 1: completed. Four hundred pregnant and ninety seven mothers (primi) were recruited and followed-up in suburban area near the capital Dhaka city in Bangladesh. All demographic, socio-economic, nutritional status and all the related laboratory investigations with pregnancy screening, genetics and epigenetics parameters were assessed. Some important findings of Phase 1:
Visit-1 (at 10 to 14 wks of gestation):
- Nutritional status of pregnant mother: Under-nutrition- 30.3%, normal weight- 47.5 and overweight and obesity- 22.2%
- Vitamin D deficiency: deficient (<30 nmol/l)- 50%, insufficient (30-79.9 nmol/l)- 49% and replete (>80 nmol/l)- 1%
- Vitamin B12 deficiency: deficient (<200 pg/ml)- 17%, normal- 82% and high (>400 pg/ml)- 1%
- Homocysteine deficiency: deficient (<5 umol/l)- 7%, normal- 73% and high (>15 umol/l)- 20%
- Folate deficiency: deficient (<3 ng/ml)- 0.25%, normal- 70% and high (>17 ng/ml)- 30%
- Glucose intolerance: Prediabetes (IFG+IGT)- 20.4%, Diabetes- 6.8%
- Glucose dysregulation based on nutritional status: : Undernutrition- 24%, normal weight- 17.4%, overweight – 36.5% and obesity- 55.4%
Visit-2 ((24 to 28 wks of gestation)):
- Prevalence of gestational diabetes (GDM): 19.4%
Visit- 3: (during delivery) :
- Mean ±SD of Birth weight (kg): 2.8±0.39 and poderal index: 2.92±0.46; 75th percentile of cord insulin: 12 µU/ml and HOMA-IR: 2.4
- Significant association between Folate, vitamin B12 and homocystine levels in neonates
2.Phase 2: Randomized open-label phase 2 trial.
The overall objective of this study is
- To pilot a complex intervention during pregnancy involving personalized micronutrient supplementation (Vit D and Vit B12) and lifestyle advice.
- In the same location, 900 pregnant women in the 1st trimester of pregnancy will be recruited and will be randomized to two arms, control and intervention.
Study updates (Phase 2):
- Start date: 10th August 2015
- Total subjects recruitment (15.12.2014): 823
- Community awareness program: 4
- Development of posters: 4
- Development of leaflets:- 1
- GIFTs News-letter: 3
- International GIFTs meeting: 2
- Total manpower: 68
- Six (6) manuscripts have been prepared for peer reviewed journal based on Phase 1 findings