Myo-Inositol, Probiotics, and Micronutrient Supplementation From Preconception for Glycemia in Pregnancy: NiPPeR International Multicenter Double-Blind Randomized Controlled Trial

Study answer

What this study found

Primary outcome: no difference in gestational glycemia at 28 weeks between groups after adjustment for site, ethnicity, and preconception glycemia. GDM incidence: 24.8% intervention vs 22.6% control (aRR 1.22 [0.92–1.62]); not statistically significant. Birth weight and gestational age at birth were similar. Preterm birth reduced with intervention (5.8% vs 9.2%; aRR 0.43 [0.22–0.82]); late preterm births and PPROM also reduced; PPROM incidence lower (2.9% vs 6.8%; aRR 0.39 [0.16–0.97]). Major postpartum hemorrhage lower in intervention (3.1% vs 8.2%; aRR 0.44 [0.20–0.94]). No differences in…

Study & population

International, multicenter, double-blind randomized controlled trial enrolling 1,729 women aged 18–38 planning conception from the U.K., Singapore, and New Zealand.

Intervention

Preconception- and pregnancy-started supplementation with myo-inositol (4 g/day), probiotics (Lactobacillus rhamnosus NCC 4007; Bifidobacterium animalis subsp.

Key limitation

Generalizability limited by underrepresentation of Latina and Native American populations and only a few Black and Polynesian participants; study population largely not overweight/obese, limiting applicability to higher-risk groups; conducted in high-resource settings; microbiome data not collected to confirm…

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Original abstract