The incidence of low birth weight (LBW) in India is high, at about 30%. The conceptual framework for this project is based on three lines of thought relating to the prevention of LBW: First, that protein (specifically the amino acids arginine and methionine) intake may have major regulatory roles in the physiological adaptation to pregnancy and for foetal growth and development; second, that vitamin A status is related to kidney development; and third, that the high iron intake during pregnancy could have long term atherogenic effects on the foetus through oxidative stress.
Specific objectives of the project:
To conduct an intervention trial of a daily supplement of 500 ml of skimmed milk in the 2nd and 3rd trimester of pregnancy, in low BMI Indian women, and to measure methionine and arginine kinetics in the 1st and 3rd trimester, as well as birth outcomes and placental characteristics
To conduct an intervention trial of a daily supplement of beta carotene in 3rd trimester and to assess change in vitamin A status using stable isotope technique, as well as newborn kidney volume and function and placental characteristics
To create a normative database of 450 placentae from well characterized Indian pregnancies, to establish standard operating procedures for the:
Measurement of placental and organ development in-utero
Measurement of placental blood flow by Doppler ultrasonography
Collection of placentae in labour rooms with complete morphological and histological examination, as well as the establishment of methods for taking bits of placenta for further molecular characterization
Methylation and gene-expression of specific candidate genes of specific pathways
To evaluate the effects of iron given during pregnancy on the antioxidant status and lipoprotein function of maternal and cord blood as an indicator of maternal/foetal oxidative status at the time of birth
The outcomes of this proposal will allow us to specifically understand the effect of food-based approaches (protein intake and vitamin A or its precursors) during pregnancy. It will also establish methods for collecting placentae and this will allow for assessing placental biomarkers including those for epigenetics and oxidative stress, as well as for storing them for future normative data analyses.