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Jul082011

Drugging Moms to Slim Down Their Babies

Jupiterimages/Thinkstock(LONDON) -- How far will we go to prevent childhood obesity? U.K. researchers are bringing the battle against obesity to babies still in the womb.

In this novel approach, which will ultimately enlist 400 pregnant women in the U.K., obese pregnant women will be given the diabetes drug Metformin in hopes of reducing their infant's chance of developing heart disease, obesity, and type 2 diabetes later in life.

The study, funded by the U.K. government, will be one of the most extensive tests to date of a concept known as fetal programming -- changing the environment of the womb to affect the health of the child.

Doctors already use "fetal programming" in less extreme ways by encouraging pregnant women to take prenatal supplements, make dietary changes, and avoid drug and alcohol use. This study promises to introduce a whole new level that might one day be commonplace: using medications that the mother otherwise wouldn't need in order to tweak the fetal environment.

Natural fetal programming "is a complex process that's evolved over millions of years to help a fetus adapt to the world it will...encounter after birth," says Dr. Alison Stuebe, an assistant professor of maternal fetal medicine at UNC-Chapel Hill. "It is the way the mother 'tells' her baby what the world outside will be like."

Obese women tend to have higher blood sugar during pregnancy, and these high levels of blood sugar essentially "tell" the fetus that it needs to make a lot of insulin for itself. As a result, infants born to obese mothers tend to be heavier and produce more insulin. Research shows that these bigger babies grow up into children and adults who are at increased risk for obesity, heart disease and type 2 diabetes.

By giving obese mothers-to-be the diabetes drug Metformin -- even though they do not have diabetes -- researchers will be lowering their glucose levels, hopefully mitigating the negative effects of maternal obesity.

It will take years to determine if this intervention pays off. In the short term, however, how big these infants are at birth will serve as a preliminary marker of how well the Metformin is adjusting fetal environment.

But the trial may not be as far a leap into the unknown as it seems, doctors point out:

"Metformin is not a new drug and has been given to pregnant women for years to control diabetes in pregnancy," says Dr. Alan Peaceman, chief of the division of maternal fetal medicine at Northwestern Memorial Hospital.

While diet and exercise would be the preferred intervention for obese mothers, "patients often find this difficult, especially during pregnancy. Thus, Metformin may provide an alternative option for these women with similar lifelong benefits to the fetus," adds Dr. Victoria Bae-Jump, assistant professor of gynecology oncology at UNC-Chapel Hill.

Doctors seem more concerned that this type of fetal programming intervention can only provide a partial answer to the problem of maternal obesity.

"Ultimately, it's unlikely that a single pill or nutrient is going to override all the effects of maternal obesity on infant development," says Stuebe. There are so many environmental factors in play -- poverty, abuse, stressful environments, she says, that "I'm skeptical of a magic pill to counteract all that."

Copyright 2011 ABC News Radio

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