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Author Notes:

Correspondence: giridhar@iiphh.org.

GRB is the principal investigator of this study and is awarded the intermediate fellowship from Wellcome Trust DBT India alliance. He has conceptualized, written and has taken the lead in completing manuscript through all stages of preparation and submission till publication and is the first author.

GVS has reviewed the application from the conceptualization stage and has contributed to each version of the manuscript.

DR, YA, PS, KK, MK, KD are members of MAASTHI research team who have contributed to each version of the revision and participated in the conduct of the study. Their role as authors is listed based on their contribution to the content, quality, and revision of the manuscript.

SBN, PD and AK have authorship depending on their contribution to paper.

SK has reviewed the application from the conceptualization stage and has contributed to each version of the manuscript.

For acknowledgements, please see the full article.

The authors declare that they have no competing interests.

Availability of data and materials: Requests for the datasets generated during and/or analyzed during the current study can be directed to the corresponding author. The Institutional ethics committee reviewing at IIPH-Bangalore will decide on providing the data.

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Research Funding:

The MAASTHI cohort is funded by an Intermediate Fellowship by the Wellcome Trust DBT India Alliance (Clinical and Public Health Research Fellowships).

Keywords:

  • Gestational diabetes
  • Hyperglycemia
  • Obesity
  • Birth cohort
  • Protocol
  • Lifecourse epidemiology

Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study

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Journal Title:

BMC Pregnancy and Childbirth

Volume:

Volume 16, Number 1

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Type of Work:

Article | Final Publisher PDF

Abstract:

Background: India is experiencing an epidemic of obesity-hyperglycaemia, which coincides with child bearing age for women. The epidemic can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, we developed the protocol for the proposed birth cohort of 5000 women, the recruitment for which will start in April 2016. The protocol of the study documents the processes which aim at advancing the available knowledge, linking several steps in the evolution of obesity led hyperglycemia. Methods: Maternal Antecedents of Adiposity and Studying the Transgenerational role of Hyperglycemia and Insulin (MAASTHI) is a cohort study in the public health facilities in Bangalore, India. The objective of MAASTHI is to prospectively assess the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the possible risk markers of later chronic diseases. The primary objective of the proposed study is to investigate the effect of glucose levels in pregnancy on skinfold thickness (adiposity) in infancy as a marker of future obesity and diabetes in offspring. The secondary objective is to assess the association between psychosocial environment of mothers and adverse neonatal outcomes including adiposity. The study aims to recruit 5000 pregnant women and follow them and their offspring for a period of 4 years. The institutional review board at The Indian Institute of Public Health (IIPH)-H, Bangalore, Public Health Foundation of India has approved the protocol. All participants are required to provide written informed consent. Discussion: The findings from this study may help to address important questions on screening and management of high blood sugar in pregnancy. It may provide critical information on the specific determinants driving the underweight-obesity-T2DM epidemic in India. The study can inform the policy regarding the potential impact of screening and management protocols in public healthcare facilities. The public health implications include prioritising issues of maternal glycemic control and weight management and better understanding of the lifecourse determinants in the development of T2DM.

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© 2016 The Author(s). The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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