The UPBEAT trial: Results, Implications and Ongoing Studies

Professor Jane Norman, Dr Fiona Denison, Dr Mandy Drake, Dr Shareen Forbes, Professor Rebecca Reynolds, Professor Brian Walker, Professor David Newby, Professor Gordon Murray, Professor Susan Wray, Dr Siobhan Quenby

The UPBEAT trial (UK Better Eating and Activity Trial) is the largest ever clinical study in obese pregnant women

Studies funded by Tommy’s have shown that high birthweight may be related to high blood sugar and insulin resistance in the mother during pregnancy. In the EMPOWaR study, obese women took the drug metformin during pregnancy, which restores the blood glucose and insulin resistance towards normal, to see whether it reduces excess birthweight in their babies.

Progress report: The study was completed in 2015 and the results have already been published. A total of 449 obese women took part at centres in Coventry, Sheffield and Nottingham, in addition to the Tommy’s funded centres in Edinburgh and Liverpool, following a huge amount of interest in the study from academic centres and the UK and overseas press (including an interview with Professor Jane Norman on Radio 4’s ‘Today’ programme). The women took either metformin or placebo from 12–16 weeks until delivery. We found that that, in fact, metformin did not reduce the birthweight of the babies. This means that there may be no benefit to giving metformin to severely obese women during pregnancy. It is important to show this, so that these women are not given metformin in the belief that it may provide benefit.

This study also emphasises the importance of being of normal weight before pregnancy, as it is difficult to prevent the risks that maternal obesity presents to the baby in later life once pregnancy has started. We hope to follow up the babies, to see whether exposure to metformin during pregnancy has long-term benefit.

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Tommy's funds research across the UK investigating the reasons for pregnancy complications and loss. Maternal and fetal research is underfunded and we need your support to continue. There are many small and large ways you can support us, find out more here.

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