|
1
|
Chang HF, Yong HEJ, Zhang H, Wong JT, Barton SJ, Titcombe P, Albert BB, El-Heis S, Nield H, Ong J, Lavelle L, Ramos-Nieves JM, Godin JP, Silva-Zolezzi I, Cutfield WS, Godfrey KM, Chan SY. Higher Plasma Myo-Inositol in Pregnancy Associated with Reduced Postpartum Blood Loss: Secondary Analyses of the NiPPeR Trial. Nutrients 2024; 16:2054. [PMID: 38999805 PMCID: PMC11242953 DOI: 10.3390/nu16132054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024] Open
Abstract
We previously reported that a combined myo-inositol, probiotics, and enriched micronutrient supplement (intervention) taken preconception and in pregnancy reduced postpartum blood loss (PBL) and major postpartum hemorrhage compared with a standard micronutrient supplement (control), as secondary outcomes of the NiPPeR trial. This study aimed to identify the intervention components that may contribute to this effect. Associations of plasma concentrations of myo-inositol and vitamins B2, B6, B12, and D at preconception (before and after supplementation), early (~7-weeks), and late pregnancy (~28-weeks) with PBL were assessed by multiple linear regression, adjusting for site, ethnicity, preconception BMI, parity, and previous cesarean section. Amongst 583 women, a higher concentration of myo-inositol in early pregnancy was associated with a PBL reduction [βadj -1.26 (95%CI -2.23, -0.29) mL per µmol/L myo-inositol increase, p = 0.011]. Applying this co-efficient to the increase in mean 7-week-myo-inositol concentration of 23.4 µmol/L with the intervention equated to a PBL reduction of 29.5 mL (~8.4% of mean PBL of 350 mL among controls), accounting for 84.3% of the previously reported intervention effect of 35 mL. None of the examined vitamins were associated with PBL. Therefore, myo-inositol may be a key intervention component mediating the PBL reduction. Further work is required to determine the mechanisms involved.
Collapse
Affiliation(s)
- Hsin F. Chang
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore 119074, Singapore; (H.F.C.); (J.O.)
| | - Hannah E. J. Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore; (H.E.J.Y.); (H.Z.); (J.-T.W.)
| | - Han Zhang
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore; (H.E.J.Y.); (H.Z.); (J.-T.W.)
| | - Jui-Tsung Wong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore; (H.E.J.Y.); (H.Z.); (J.-T.W.)
| | - Sheila J. Barton
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; (S.J.B.); (P.T.); (S.E.-H.); (H.N.)
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; (S.J.B.); (P.T.); (S.E.-H.); (H.N.)
| | - Benjamin B. Albert
- Liggins Institute and a Better Start—National Science Challenge, The University of Auckland, Auckland 1023, New Zealand; (B.B.A.); (W.S.C.)
| | - Sarah El-Heis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; (S.J.B.); (P.T.); (S.E.-H.); (H.N.)
- NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Heidi Nield
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; (S.J.B.); (P.T.); (S.E.-H.); (H.N.)
| | - Judith Ong
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore 119074, Singapore; (H.F.C.); (J.O.)
| | - Luca Lavelle
- Nestlé Research Centre, 1000 Lausanne, Switzerland; (L.L.); (J.M.R.-N.); (J.-P.G.)
| | | | - Jean-Philippe Godin
- Nestlé Research Centre, 1000 Lausanne, Switzerland; (L.L.); (J.M.R.-N.); (J.-P.G.)
| | - Irma Silva-Zolezzi
- Research & Development, Nestlé Product Technology Center—Nutrition, 1800 Vevey, Switzerland;
| | - Wayne S. Cutfield
- Liggins Institute and a Better Start—National Science Challenge, The University of Auckland, Auckland 1023, New Zealand; (B.B.A.); (W.S.C.)
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK; (S.J.B.); (P.T.); (S.E.-H.); (H.N.)
- NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynaecology, National University Hospital, Singapore 119074, Singapore; (H.F.C.); (J.O.)
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore; (H.E.J.Y.); (H.Z.); (J.-T.W.)
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | | |
Collapse
|
|
2
|
Vitamin D-Related Risk Factors for Maternal Morbidity and Mortality during Pregnancy: Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194124. [PMID: 36235776 PMCID: PMC9572094 DOI: 10.3390/nu14194124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/30/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL in serum) is a common health condition among pregnant women, especially in high-risk groups. Evidence has connected vitamin D levels with many health-related problems during pregnancy, including gestational diabetes and preeclampsia. Because of vitamin D’s effect on both mother and fetus, we systematically review the association between 25(OH)D level and its health effects. From a total of 143 studies, 43 came from PubMed, 4 from Cochrane, and 96 from EMBASE. After screening, we identified 38 studies as candidates for inclusion. Ultimately, we limited this review to 23 articles originating from 12 countries, written in English or Spanish, and conducted between 2010 and 2022. We conducted this review according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and evaluated the quality and strength of the evidence by using the Navigation Guide Systematic Review Methodology (SING). These systematic reviews summarize findings that support vitamin D’s role in reducing risks of multiple outcomes and the possible contribution of adequate vitamin D levels to a healthy pregnancy.
Collapse
|