E-Poster 63rd Endocrine Society of Australia Annual Scientific Meeting 2020

Preconception weight modulation better optimises maternal metabolic outcomes compared to intrapartum weight modulation in late gestation mice. (#55)

Natassia Rodrigo 1 2 3 , Hui Chen 4 , Carol Pollock 2 3 5 , Sarah Glastras 1 2 3
  1. Endocrinology, Royal North Shore Hospital, St Leonards, NSW, Australia
  2. University of Sydney, Sydney, NSW, Australia
  3. Kolling Institute of Medical Researh, Sydney, NSW, Australia
  4. University of Technology, Sydney, Sydney, NSW, Australia
  5. Renal Department, Royal North Shore Hospital, Sydney, NSW, Australia

Background and aims:

Maternal obesity affects 20% of pregnant women and negatively impacts metabolic health in mothers and offspring. Maternal complications include gestational diabetes, fatty liver disease and increased rates of cardiovascular disease, while offspring are at increased risk of obesity and diabetes. Intrapartum diet modification has shown limited efficacy in improving health outcome in mother and offspring. To date, no studies have addressed whether pre-conception maternal weight loss improves outcomes in obese mothers and offspring. We aimed to determine if weight loss prior to pregnancy by diet modification, improves maternal and offspring weight and metabolic outcomes compared to intrapartum diet modification. 

Methods:

C57BL/6 dams were fed a high fat diet (HFD) versus chow diet for 8 weeks. Then, HFD-fed dams were continued on HFD, switched to chow pre-pregnancy, or switched to chow once pregnancy was confirmed. Pregnancy rates were observed after male co-housing. Maternal anthropometriy, glucose tolerance and metabolic markers were measured before and after diet change, and at late gestation. Dams were sacrificed during late pregnancy, or delivered their offspring and the offspring’s anthropometry, and glucose tolerance assessed at postnatal week 12. 

Results:

HFD-fed dams had greater weights and reduced glucose tolerance compared to control (both p<0.0001). Following preconception diet modification, insulin resistance and body weight were reduced (p<0.001), with improved fecundity. In late gestation, glucose tolerance was optimised with preconception diet change, compared to intrapartum diet change (area under the curve 81.97 vs 100.1mmol/L/min, p=0.0008). Offspring of obese mothers with preconception weight loss had lower body weight (p<0.001) and improved glucose tolerance (p<0.01).    

Conclusions:

Preconception dietary change to induce weight loss improves maternal weight and metabolic outcomes in pregnancy compared to intrapartum dietary change , with transgenerational benefits to offspring. Therefore, obese women should be targeted for pre-conception weight loss to improve intergenerational metabolic outcomes.