title: Effect of hyperglycaemia in pregnancy on adiposity in their infants in India: a protocol of a multicentre cohort study.
abstract: BACKGROUND
  The carbohydrate 'fuel' metabolism in a pregnant woman may have a long-term impact on the development of her offspring ('fuel-mediated teratogenesis' hypothesis) including in utero exposure to maternal hyperglycaemia leading to fetal hyperinsulinaemia, and the consequent increase in fetal fat cells. Therefore, a feed-forward loop can exist of rising adiposity and hyperinsulinaemia throughout childhood, perhaps leading to obesity and diabetes in later life. There is a need for prospective examination of body fat distribution in children born to mothers with different glycaemic levels to understand the plausible association between glucose metabolism and future risk of diabetes in offspring. The hypothesis is that maternal glucose levels in pregnant women are related to skinfold thickness in their infants.
  
  
  METHODS
  Hyperglycaemia in pregnancy and adiposity in infants is a multicentre cohort study to evaluate the effects of glucose levels in pregnancy on the risk of adverse infant outcomes, especially in predicting the risk of chronic diseases in infants. The study aims to recruit 1045 participants over a period of 1 year, who will be followed up irrespective of their glycaemia status for a period of 15 months, beginning in the 24th week of gestation. The glucose levels in pregnant women would be obtained through oral glucose tolerance testing. The primary outcome of our study was skinfold thickness in infants at the age of 6 weeks, 3rd and 9th month (as a proxy for fat distribution/adiposity).
  
  
  BACKGROUND
  The institutional review board at The Indian Institute of Public Health (IIPH)-Hyderabad, Public Health Foundation of India has approved the protocol. All participants are required to provide written informed consent.
authors: IIPH-H, Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India.
authors: Giridhara R
authors: GR
authors: Babu
authors: IIPH-H, Bangalore Campus, Public Health Foundation of India, Bangalore, Karnataka, India.
authors: Lavanya
authors: L
authors: Garadi
authors: IIPH Hyderabad, Hyderabad, Andhra Pradesh, India Faculty of Infectious and Tropical Diseases, Department of Clinical Research, Public Health Disability, London School of Hygiene & Tropical Medicine, London, UK.
authors: G V S
authors: GV
authors: Murthy
authors: Faculty of Epidemiology and Population Health, Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
authors: Sanjay
authors: S
authors: Kinra
mesh_terms: D050154:Adiposity; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia; D007194:India; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications; D012107:Research Design; D012885:Skinfold Thickness
keywords: Epidemiology