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Clinical Research

Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

Background/Objective

Obesity increases maternal morbidity and adversely affects child health. Maternal inflammation may play a role in adverse outcomes. The objective of this study was to determine whether providing a higher dose of antioxidant micronutrients to pregnant women with obesity would raise concentrations of key antioxidant vitamins and impact inflammation and oxidative stress during pregnancy.

Subjects/Methods

This was a double-blind, randomized controlled trial. We recruited pregnant women with a body mass index (BMI) ≥ 30 kg/m2 at their initial prenatal visit ( < 13 weeks gestation) and collected blood and urine samples at baseline, 24–28 weeks, and 32–36 weeks to measure micronutrient concentrations (vitamin C, E, B6 and folate), markers of inflammation (C-reactive protein, interleukin-6, 8, and 1β) and oxidative stress (8-epi-PGF2α and malondialdehyde). We collected maternal and infant health data from enrollment to delivery as secondary outcomes. We enrolled 128 participants (64 in each arm), and 98 (49 in each arm) completed follow-up through delivery.

Intervention

Both groups received a standard prenatal vitamin containing the recommended daily allowance of micronutrients in pregnancy. In addition, the intervention group received a supplement with 90 mg vitamin C, 30 αTU vitamin E, 18 mg vitamin B6, and 800 μg folic acid, and the control group received a placebo.

Results

The intervention group had higher vit B6 (log transformed (ln), β 24–28 weeks: 0.76 nmol/L (95% CI: 0.40, 1.12); β 32–36 weeks: 0.52 nmol/L (95% CI: 0.17, 0.88)) than the control group. Vitamins C, E, erythrocyte RBC folate concentrations did not differ by randomization group. The intervention did not impact biomarkers of inflammation or oxidative stress. There were no differences in maternal or neonatal clinical outcomes by randomization group.

Conclusions

Higher concentrations of antioxidant vitamins during pregnancy increased specific micronutrients and did not impact maternal inflammation and oxidative stress, which may be related to dosing or type of supplementation provided.

Clinical trial registration

Clinical Trial Identification Number: NCT02802566; URL of the Registration Site: www.clinicaltrials.gov.

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Fig. 1
Fig. 2: Pregnancy serum markers (natural log(ln) transformed) by study (PNV) and standard vitamin study arms.

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Data availability

Limited data sets and data dictionaries will be made available by secure, electronic transmission from ten years of study publication to investigators who provide a detailed analysis plan that is agreed upon by the co-authors of this manuscript.

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Acknowledgements

We would like to thank the participants, without whom this study would not have been possible. We would also like to thank Annie Penfield-Cyr, MS and Charis Benjamin, BS for their important contributions to this study.

Funding

SS was supported by K23 HD 074648, K23 HD 074648 S1, and The Charles Hood Foundation.

Author information

Authors and Affiliations

  1. Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Sarbattama Sen & Sara Cherkerzian

  2. JM USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA

    Sarbattama Sen & Simin N. Meydani

  3. Harvard Medical School, Boston, MA, USA

    Sarbattama Sen, Sara Cherkerzian, Mary Herlihy, Michele R. Hacker, Thomas F. McElrath, David E. Cantonwine, Raina Fichorova & Emily Oken

  4. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Mary Herlihy & Michele R. Hacker

  5. Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Boston, MA, USA

    Thomas F. McElrath, David E. Cantonwine & Raina Fichorova

  6. Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA

    Emily Oken

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SS, SC, MH, MRH, TM, RF, EO, and SNM have all contributed to the study design, data acquisition, interpretation of results, and writing or revising the manuscript.

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Correspondence to Sarbattama Sen.

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Sen, S., Cherkerzian, S., Herlihy, M. et al. Supplementation with antioxidant micronutrients in pregnant women with obesity: a randomized controlled trial. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01472-z

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