RISK MANAGEMENT AND HEALTH SUPPORT FOR PREGNANT WOMEN USING INOSITOLS

To evaluate the association between myo-inositol supplementation and the risk of fetal macrosomia in pregnant women with a history of large-for-gestational-age infants, and to assess its relationship with gestational weight gain in women with overweight or obesity.

A prospective observational study was conducted in antenatal clinics and the Almaty Center for Perinatology and Pediatric Cardiac Surgery. Myo-inositol supplementation was recommended as part of routine clinical practice and taken daily for up to 6 months. Participants attended four visits: baseline (<12 weeks), 20 weeks, 30 weeks, and delivery. The main group included women with a BMI of 25-35 kg/m² and a history of delivering infants weighing >4000 g. The comparison group was formed using a clinical risk scoring system to improve group comparability.

Gestational weight gain was significantly lower in the myo-inositol group (11.82 kg) compared with the comparison group (17.85 kg; p<0.001). The incidence of macrosomia was lower in women who used myo-inositol supplementation (5.9% vs. 55.9%). Mean neonatal birth weight was also lower in the supplementation group (3658.9 g vs. 3972.5 g), with a mean difference of 313.6 g (95% CI 173.5-453.8). Emergency cesarean delivery occurred less frequently in the supplementation group (3.9% vs. 15.7%), indicating improved obstetric outcomes.

In this high-risk cohort, the use of myo-inositol supplementation was associated with lower gestational weight gain and a lower incidence of fetal macrosomia. These findings suggest a potential beneficial role of myo-inositol in the prevention of excessive fetal growth; however, randomized controlled trials are needed to confirm causality.