Maternal Carotenoids Across Pregnancy Study

Study Overview
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Brief Summary
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Before infants are born, they depend on their mother to provide the nutrients necessary to grow and develop, such as iron, folic acid, iodine and other vitamins and minerals. Pregnant people also rely on good nutrition to support their own health. In addition to essential nutrients, vitamins, and minerals, there are other natural components found in fruits and vegetables, called phytochemicals, that may support maternal and fetal health during pregnancy. While more is known about the role of phytochemicals in adult health, surprisingly little is known about phytochemical nutrition during pregnancy. This study focuses on a group of phytochemicals, called carotenoids, during pregnancy. The study will determine if and why levels of carotenoids in the body change across the course of pregnancy. Understanding carotenoid nutrition during pregnancy will improve the understanding ofnutrition needs of expectant mothers and their infants. To study these questions, both health pregnant and non-pregnant female adults will report on their dietary intake and participate in body measurements, health surveys, and carotenoid measurements of eyes, skin, and blood at time points corresponding with the first, second, and third trimesters of pregnancy as well as post-partum.

Detailed Description
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What a pregnant person eats is important for their own health and the health of their infant during pregnancy and after birth. Fruits and vegetables contain colorful substances called carotenoids which support the nutritional needs of the pregnant person and the infant, may fight inflammation, and may even benefit the person's memory and thinking ability. A person's carotenoid status can be measured with a blood sample and with optical measurements of the skin and eye. What isn't known, is if or why a pregnant person's carotenoid status changes over the course of pregnancy and the early post-partum period, and if those changes have consequences for pregnant person's and infant's health. The goal of this study is to better understand how and why body levels of carotenoids, change during pregnancy and the post-partum period. We will study whether these changes can be explained by pregnancy, a person's diet, and changes in body composition. We will study if changes in a female's carotenoid status are associated with changes in memory or thinking ability, levels of inflammation, and her infant's carotenoid levels. Ultimately, this information can guide nutrition advice for future pregnant people. This study involves 5 study visits for the pregnant or non-pregnant adult female participants with an option to enroll infants for the final, post-partum, visit. For the four follow-up visits, adult participants will have body measurements, will complete surveys, and will provide a blood sample. At the final visit, lactating participants will be asked to provide a milk sample. If enrolled, infant participants will provide an optional blood sample, have body measurements, have an optical skin measurement, and their participating adult guardian will complete an infant eating survey.

Official Title
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Effect of Pregnancy and Lactation on Carotenoid Status and Bioactivity

Conditions
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Healthy Nutrition, Pregnancy Related

Intervention / Treatment
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* Other: Carotenoid Intake
* Other: Serum carotenoid concentration


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant group a pregnancy confirmed by positive pregnancy test and/or ultrasound pre-pregnancy BMI 18.5-29.9 kg/m^2 can speak, read, and understand English agrees to take the prescribed daily prenatal multivitamin as recommended by their licensed prenatal healthcare provider throughout the study. Non-pregnant group current BMI that is lean 18.5-29.9 kg/m^ can speak, read, and understand English agrees to continue taking any daily multivitamins or supplements throughout the study consumes alcohol moderately as outlined by current guidelines. Infants born at term (37 weeks gestation or more) if infant was one of multiple births, only one sibling may be enrolled. Exclusion Criteria: Metabolic, kidney, liver, digestive, or malabsorptive disorders with special dietary recommendations for the adult female or infant currently uses tobacco, or drugs; consumes alcohol beyond current recommendations (zero in pregnancy, 1 drink daily average for non-pregnant) adult female currently taking any isolated carotenoid supplements or high carotenoid (>2 mg/d) supplements adult female currently consumes an exclusively vegan or vegetarian diet adult female uses medications that interfere with dietary fat absorption adult female has history of endocrine disorders requiring hormone administration (with the exception of medically managed hypothyroidism). pregnant adult female has been informed by her doctor that she will need to take hormones during her pregnancy adult female has current vision condition or disease that prevents them from seeing clearly regardless of corrective lenses. adult female is currently lactating at enrollment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pregnant<br>Adult females between 18-40 years old who have a confirmed pregnancy. | Other: Carotenoid Intake<br>* Carotenoid intake assess by 24 hour dietary recalls<br>Other: Serum carotenoid concentration<br>* Serum total carotenoid concentration<br>|
| Non-pregnant<br>Adult females between 18-40 years old who do not have a confirmed pregnancy. | Other: Carotenoid Intake<br>* Carotenoid intake assess by 24 hour dietary recalls<br>Other: Serum carotenoid concentration<br>* Serum total carotenoid concentration<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Serum Total Carotenoid Concentrations - 1st Trimester Equivalent | Sum of all major carotenoid species in serum collected from fasting participant. | 1st Trimester Equivalent: 8 weeks 0 days-13 weeks 6 days gestation (Week 0 if non-pregnant) | 
| Serum Total Carotenoid Concentrations - 2nd Trimester Equivalent | Sum of all major carotenoid species in serum collected from fasting participant. | 2nd Trimester Equivalent: 22 weeks 0 days-23 weeks 6 days gestation (or week 11-12 if non-pregnant) | 
| Serum Total Carotenoid Concentrations - 3rd Trimester Equivalent | Sum of all major carotenoid species in serum collected from fasting participant. | 3rd Trimester Equivalent: 32 weeks 0 days -33 weeks 6 days weeks gestation (week 22-23 if non-pregnant) | 
| Serum Total Carotenoid Concentrations - Post-partum | Sum of all major carotenoid species in serum collected from fasting participant. | Post-partum Equivalent: 7 weeks 0 days - 8 weeks 6 days post-partum (weeks 36-37 if non pregnant) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Skin Carotenoid Concentrations - 1st Trimester Equivalent | Skin carotenoid score measured by pressure-mediated reflection spectroscopy | 1st Trimester Equivalent: 8 weeks 0 days -13 weeks 6 days gestation (Week 0 if non-pregnant) | 
| Macular pigment optical density - 1st Trimester Equivalent | Macular pigment optical density measured by heterochromatic flicker photometry | 1st Trimester Equivalent: 8 weeks 0 days - 13 weeks 6 days gestation (Week 0 if non-pregnant) | 
| Skin Carotenoid Concentrations - 2nd Trimester Equivalent | Skin carotenoid score measured by pressure-mediated reflection spectroscopy | 2nd Trimester Equivalent: 22 weeks 0d - 23 weeks 6 days gestation (or week 11-12 if non-pregnant) | 
| Macular pigment optical density - 2nd Trimester Equivalent | Macular pigment optical density measured by heterochromatic flicker photometry | 2nd Trimester Equivalent: 22 weeks 0 days - 23 weeks 6 days gestation (or week 11-12 if non-pregnant) | 
| Skin Carotenoid Concentrations - 3rd Trimester Equivalent | Skin carotenoid score measured by pressure-mediated reflection spectroscopy | 3rd Trimester Equivalent: 32 weeks 0 days - 33 weeks 6 days weeks gestation (week 22-23 if non-pregnant) | 
| Macular pigment optical density - 3rd Trimester Equivalent | Macular pigment optical density measured by heterochromatic flicker photometry | 3rd Trimester Equivalent: 32 weeks 0 days -33 weeks 6 days weeks gestation (week 22-23 if non-pregnant) | 
| Skin Carotenoid Concentrations - Post-partum Equivalent | Skin carotenoid score measured by pressure-mediated reflection spectroscopy | Post-partum Equivalent: 7 weeks 0 days - 8 weeks 6 days post-partum (weeks 36-37 if non pregnant) | 
| Macular pigment optical density - Post-partum Equivalent | Macular pigment optical density measured by heterochromatic flicker photometry | Post-partum Equivalent: 7 weeks 0 days - 8 weeks 6 days post-partum (weeks 36-37 if non pregnant) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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carotenoids, skin carotenoids, cognitive function, pregnancy nutrition, macular carotenoids