{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:29:18Z","timestamp":1760059758207,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Research and Training Council of the university hospitals Leuven"},{"name":"Novo Nordisk\u00ae"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Metabolic bariatric surgery is a highly effective and long-lasting treatment for obesity and related chronic conditions. Women of reproductive age represent the largest group undergoing these procedures. Observational studies suggest an increased risk of preterm birth and impaired foetal growth in this population, though the underlying mechanisms remain unclear. A key hypothesis is that altered glucose metabolism, characterised by frequent hypoglycaemia and glycaemic fluctuations, may contribute to these adverse outcomes. While glycaemic variability following metabolic bariatric surgery has been documented, its pattern during pregnancy and impact on pregnancy outcomes are still underexplored. Methods: In this Belgian multicentre prospective cohort study, we will investigate glycaemic patterns during pregnancy in women who have undergone metabolic bariatric surgery. Women aged 18\u201345 years with a confirmed singleton pregnancy up to 11 weeks and 6 days and a history of Roux-en-Y gastric bypass or sleeve gastrectomy will be eligible for inclusion. Women with pregestational diabetes or those taking medication known to interfere with glucose metabolism will be excluded. All participants will receive blinded continuous glucose monitoring (Dexcom\u00ae G6) for a 10-day period at four time points throughout the pregnancy. Foetal body composition and growth will be measured during routine ultrasound; skinfolds will be measured in the neonate. The primary outcome is the association between mean glycemia and glycaemic variability on continuous glucose monitoring and birth weight. The planned sample size is ninety-five women. Linear mixed models for repeated measurements will be used for analysis. Confounders such as smoking, micronutrient deficiency, and surgery-to-conception interval will be added to the model as covariates. In a second exploratory phase, each participant in the surgical group will be matched with a control participant\u2014without a history of metabolic bariatric surgery\u2014based on pre-pregnancy BMI and age. Control participants will undergo the same study procedures, allowing for exploratory comparison of glycaemic patterns and other study outcomes. Discussion: This prospective longitudinal study will be the largest study using continuous glucose monitoring to investigate glucose metabolism during pregnancy after metabolic bariatric surgery and its impact on foetal growth and newborn body composition. Trial registration: ClinicalTrials.gov: NCT05084339. Registration date: 15 October 2021.<\/jats:p>","DOI":"10.3390\/jcm14134782","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:18:14Z","timestamp":1751883494000},"page":"4782","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Glucose Homeostasis, Metabolomics, and Pregnancy Outcomes After Bariatric Surgery (GLORIA): Protocol for a Multicentre Prospective Cohort Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8496-7723","authenticated-orcid":false,"given":"Ellen","family":"Deleus","sequence":"first","affiliation":[{"name":"Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Abdominal Surgery, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niels","family":"Bochanen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology & Metabolism, Antwerp University Hospital, 2650 Edegem, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7392-2773","authenticated-orcid":false,"given":"Dries","family":"Ceulemans","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne","family":"Debunne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, ZAS Palfijn, 2170 Merksem, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e9n\u00e9dicte","family":"Denys","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, AZ Groeninge Kortrijk, 8500 Kortrijk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-4684","authenticated-orcid":false,"given":"Roland","family":"Devlieger","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Obstetrics and Gynaecology, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ina","family":"Geerts","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1371-442X","authenticated-orcid":false,"given":"Annouschka","family":"Laenen","sequence":"additional","affiliation":[{"name":"Center of Biostatics and Statistical Bioinformatics, KU Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisbeth","family":"Jochems","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Antwerp University Hospital, 2650 Edegem, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Els","family":"Lannoey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Imelda Bonheiden, 2820 Bonheiden, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-1157","authenticated-orcid":false,"given":"Matthias","family":"Lannoo","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Abdominal Surgery, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Loccufier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, AZ Sint-Jan Brugge, 8000 Brugge, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toon","family":"Maes","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Imelda Hospital Bonheiden, 2820 Bonheiden, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9500-608X","authenticated-orcid":false,"given":"Joke","family":"Marlier","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Ghent University Hospital, 9000 Gent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"Morrens","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, ZAS Palfijn, 2170 Merksem, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nele","family":"Myngheer","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, General Hospital Groeninge Kortrijk, 8500 Kortrijk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luna","family":"Tierens","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-5065","authenticated-orcid":false,"given":"Griet","family":"Vandenberghe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Ghent University Hospital, 9000 Gent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0529-7256","authenticated-orcid":false,"given":"Annick","family":"Van den Bruel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, AZ Sint-Jan Brugge, 8000 Brugge, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1040-0046","authenticated-orcid":false,"given":"Lien","family":"Van den Haute","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, AZORG, 9300 Aalst, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-784X","authenticated-orcid":false,"given":"Bart","family":"Van der Schueren","sequence":"additional","affiliation":[{"name":"Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium"},{"name":"Department of Endocrinology, University 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