The UPBEAT trial: Results, Implications and Ongoing Studies

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

Investigators: 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

Summary: 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.

Read more about our research

  • Three pregnant women sitting in a row

    Research into health and wellbeing in pregnancy

    In addition to our core work on miscarriage, stillbirth, preterm birth and pre-eclampsia, Tommy’s also funds projects that research the effects of lifestyle and well-being on pregnancy and on the later life of the child.

  • Team of researchers

    Research into stillbirth

    When a baby dies after 24 weeks of gestation, it is called a stillbirth. Around 2.6 million babies are stillborn each year [1]. Tommy’s research is helping to change this.

  • Nurse monitoring premature baby in hospital

    Research into premature birth

    Around 60,000 babies are born prematurely each year in the UK [1]. These babies are vulnerable – they are born before they have grown to cope with the outside world. Tommy’s is saving lives by researching how we can prevent premature births by finding those at risk early on.

  • Clinical researcher looking at test tube

    Research into miscarriage

    1 in 4 women experience miscarriage in their lifetimes [1], and 1 in 100 have 3 or more miscarriages in a row [2]. We want to change this so that women no longer have to suffer the trauma of losing their babies.