Gestational route to healthy birth (GaRBH): protocol for an Indian prospective cohort study

Vipin Gupta*, Ruchi Saxena, Gagandeep Kaur Walia, Tripti Aggarwal, Warwick B Dunn, Caroline L Relton, Ulla Sovio, Aris Papageorghiou, George Davey Smith, Rajesh Khadgawal, M. P. Sachdeva

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Introduction: Pregnancy is characterized by a high rate of metabolic shifts from early to late phases of gestation in order to meet the raised physiological and metabolic needs. This change in levels of metabolites is influenced by gestational weight gain (GWG) which is an important characteristic of healthy pregnancy. Inadequate/excessive GWG has short and long term implications on maternal and child health. Exploration of gestational metabolism is required for understanding the quantitative changes in metabolite levels during the course of pregnancy. Therefore, our aim is to study trimester-specific variation in levels of metabolites in relation to GWG and its influence on foetal growth and newborn anthropometric traits at birth.

Methods and analysis: A prospective longitudinal study is planned (start date: February, 2018; end date: March, 2023) on pregnant women that are being recruited in the first trimester and followed in subsequent trimesters and at the time of delivery (total 3-follow-ups). The study is being conducted in a hospital located in Bikaner district (66% rural population), Rajasthan, India. The estimated sample size is of 1000 mother-offspring pairs. Information on gynaecological and obstetric history, socioeconomic position, diet, physical activity, tobacco and alcohol consumption, depression, anthropometric measurements and blood samples is being collected for metabolic assays in each trimester using standardized methods. Mixed effects regression models will be used to assess the role of gestational weight in influencing metabolite levels in each trimester. The association of maternal levels of metabolites with foetal growth, offspring’s weight and body composition at birth will be investigated using regression modelling.

Ethics and dissemination: The study has been approved by the ethics committees of the Department of Anthropology, University of Delhi and Sardar Patel Medical College, Rajasthan. We are taking written informed consent after discussing the various aspects of the study with the participants in the local language.
Original languageEnglish
Article numbere025395
Number of pages12
JournalBMJ Open
Issue number4
Early online date1 May 2019
Publication statusPublished - 1 May 2019

Bibliographical note

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.


  • Birth cohort
  • India
  • Metabolomics in Pregnancy
  • Foetal growth
  • Epidemiology and Developmental origin


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