title: Maternal antecedents of adiposity and studying the transgenerational role of hyperglycemia and insulin (MAASTHI): a prospective cohort study : Protocol of birth cohort at Bangalore, India.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Wellcome Trust-DBT India alliance Intermediate Research Fellow in Public Health, Additional Professor, Public Health Foundation of India (PHFI), IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India. giridhar@iiphh.org.
authors.forename: Giridhara R
authors.identifier: 0000-0003-4370-8933
authors.initials: GR
authors.lastname: Babu
authors.affiliation: Indian Institute of Public Health-Hyderabad, Plot # 1, A.N.V. Arcade, Amar Co-op Society, Kavuri Hills, Madhapur, Hyderabad, 500033, India.|ICEH, London School of Hygiene & Tropical Medicine, 3rd Floor, South Courtyard, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Gvs
authors.initials: G
authors.lastname: Murthy
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.forename: R
authors.initials: R
authors.lastname: Deepa
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.lastname: Yamuna
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.lastname: Prafulla
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.forename: H Kiran
authors.initials: HK
authors.lastname: Kumar
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.forename: Maithili
authors.initials: M
authors.lastname: Karthik
authors.affiliation: Research team of MAASTHI, Public Health Foundation of India, IIPH-H, Bangalore campus, SIHFW premises, Beside leprosy hospital, 1st cross, Magadi road, Bangalore, 560023, India.
authors.forename: Keerti
authors.initials: K
authors.lastname: Deshpande
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Hampton House 755, Baltimore, MD, 21205, USA.|Centre for Diet and Activity Research, MRC Epidemiology, University of Cambridge, Cambridge, UK.
authors.forename: Sara E
authors.initials: SE
authors.lastname: Benjamin Neelon
authors.affiliation: Centre for Control of Chronic Conditions (CCCC, Public Health Foundation of India (PHFI), New Delhi, India.|Centre for Chronic Disease Control (CCDC), New Delhi, India.|Department of Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.|Emory Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322, USA.
authors.forename: D
authors.initials: D
authors.lastname: Prabhakaran
authors.affiliation: Nutrition Division, St John's Research Institute, Bangalore, India.|Nutrition Society of India, National Institute of Nutrition Campus, Hyderabad, 500 007, India.|IAEA Collaborating Centre for Stable Isotope Technologies in Nutrition, St John's Research Institute, Bangalore, India.|International Nutrition Foundation Protein Advisory Group and Chair, Expert Committee on Obesity, ICMR, New Delhi, India.
authors.forename: Anura
authors.initials: A
authors.lastname: Kurpad
authors.affiliation: Reader in Clinical Epidemiology & Honorary Consultant in Paediatric Obesity - London School of Hygiene & Tropical Medicine & University College London Hospital, London, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kinra
mesh_terms: D050154:Adiposity; D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology* / Q000473:pathology; D007194:India; D007223:Infant; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000473:pathology; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000209:etiology* / Q000473:pathology; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000209:etiology* / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D012885:Skinfold Thickness
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Birth cohort; Gestational diabetes; Hyperglycemia; Lifecourse epidemiology; Obesity; Protocol