Category: Obstetrics & Gynaecology

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Amniotic Fluid Protects Both Baby and Birthing Parent, Research Finds

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Researchers at Oregon Health & Science University have made new discoveries about amniotic fluid, which is historically not well understood in medical research due to the difficulty in obtaining it during pregnancy, especially across gestation in birthing parents.

In addition to providing much-needed cushion and protection for the foetus, amniotic fluid also aids in development of vital organs – especially the lungs, digestive tract and skin – and stabilises the temperature inside the womb.

The new study, published in the journal Research and Practice in Thrombosis and Haemostasis, found that the addition of amniotic fluid to plasma improves the blood’s ability to thicken and clot, which is a critical and likely a protective function throughout pregnancy and during delivery for both the birthing parent and the baby. It also appears to offer other unexpected functions, such as serving as a ‘pre-milk’ for foetuses.

The mechanism of amniotic fluid’s role in foetal development is not well understood and is understudied: The OHSU study is one of the first to identify how the features and properties of amniotic fluid change over time, especially those properties that play a role in thickening the blood, and how those changes can affect how maternal blood coagulates. If a pregnant person’s blood does not clot properly, it can create life-threatening complications for the foetus and birthing parent, including excessive bleeding during pregnancy and delivery.  

“We have always known that amniotic fluid is very important for foetal development and growth, but we don’t know much about it beyond that,” said the study’s corresponding author Jamie Lo, MD, MCR., associate professor of obstetrics and gynaecology (maternal-foetal medicine) in the OHSU School of Medicine, and Division of Reproductive & Developmental Sciences at the Oregon National Primate Research Center, or ONPRC. “We examined amniotic fluid across the pregnancy and found that indeed the composition and proteins in the amniotic fluid do change to match the growing needs of the developing baby.”

This discovery prompted Lo and her team to work with scientists in the Department of Biomedical Engineering at OHSU to take a deeper dive into the potential protective factors of amniotic fluid, and consider potential regenerative and therapeutic uses that could be developed down the road.

The research involved a multidisciplinary team including Lo, Chih Jen Yang, MD, Lyndsey Shorey-Kendrick, PhD, Joseph Shatzel, MD, MCR, Brian Scottoline, MD, PhD, and Owen McCarty, PhD.

Researchers analysed the properties of amniotic fluid obtained by amniocentesis, a prenatal test that involves sampling a small amount of amniotic fluid to examine the health of the pregnancy, from both human and non-human primates at gestational-age matched timepoints. The findings showed that amniotic fluid increases blood clotting through key fatty acids and proteins that change each trimester and help regulate coagulation.

With the untapped potential for amniotic fluid to aid in diagnosing and treating various prenatal conditions, researchers are now collaborating with Sanjay Malhotra, PhD, professor of cell, developmental and cancer biology in the OHSU School of Medicine, to target disorders of pregnancy – including disorders that affect the blood and blood-forming organs – that could benefit from the protective properties of proteins and other compounds within amniotic fluid.

Researchers are eager to learn more about the potential uses of amniotic fluid components and how they might be harnessed to improve prenatal and maternal health.

“Babies born prematurely miss out on critical weeks developing within amniotic fluid,” said the study’s co-senior author Brian Scottoline, MD, PhD, professor of paediatrics (neonatology), OHSU School of Medicine. “But if we have a better understanding of amniotic fluid, how it develops and what properties are valuable for what functions, that opens up many new possibilities for creating new therapies.”

“Through our research, our team is learning that amniotic fluid may be a critical precursor to breast milk – almost like ‘pre-term’ milk for a foetus in utero. With that analogy, could we eventually develop a formula that’s fit for preterm babies that mimics amniotic fluid, aiding in growth and development and protecting babies from complications of being born prematurely?” Lo added. “This is really the tip of the iceberg for what’s possible.”

Source: Oregon Health & Science University

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Oxytocin Can ‘Pause’ Pregnancy After Conception

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Oxytocin, a hormone already known for its role in childbirth, milk release, and mother–infant bonding, may have a newfound purpose in mammalian reproduction. In times of maternal stress, the hormone can delay an embryo’s development for days to weeks after conception, a new study in rodents shows. According to the authors, the findings about so-called “diapause” may offer new insights into pregnancy and fertility issues faced by humans.

Led by researchers at NYU Langone Health, the study explored diapause, in which an embryo temporarily stops growing early in its development before it attaches to the lining of its mother’s uterus, a key step leading to the formation of the placenta. Known to occur in species as varied as armadillos, giant pandas, and seals, diapause is thought to have evolved to help expectant mothers preserve scarce resources (e.g., breast milk) by delaying birth until they have enough to successfully take care of their offspring.

Although recent studies have uncovered evidence that a form of diapause may occur in humans, the underlying mechanisms behind it have until now remained unclear.

The findings in mice showed that one type of stress that may cause diapause is milk production and release (lactation), as it requires a mother to expend bodily resources nursing already-born pups, and supplying nutrients to pups growing in the womb, at the same time. The study revealed that the time between conception and birth, typically 20 days for these animals, was delayed by about a week in pregnant rodents that were already nursing a litter.

Further, the research team showed that this delay was brought about by a rise in the production of oxytocin, levels of which are known to go up as a mother lactates. To confirm this role for the hormone, the researchers exposed mouse embryos in the lab to a single dose (either 1 microgram or 10 micrograms) of oxytocin, and found that even these small amounts delayed their implantation in the uterus by as much as three days. The team found that the chemical did more than just pause pregnancy: oxytocin surges that were large enough to mimic the amounts and timing measured during nursing caused loss of pregnancy in the mice in nearly all cases.

“Our findings shed light on the role of oxytocin in diapause,” said study co-author Moses V. Chao, PhD, a professor at NYU Grossman School of Medicine. “Because of this newfound connection, it is possible that abnormalities in the production of this hormone could play roles in infertility, premature or delayed birth, and miscarriage.”

A report on the findings appears in Science Advances in a special issue focused on women’s health.

In another part of the study, the team searched for a mechanism that would allow embryos to react to an oxytocin surge. They found that the hormone can bind to special proteins called receptors on the surface of a layer of cells known as the trophectoderm, which surrounds the early embryo and eventually forms the placenta.

Notably, mouse embryos that were genetically altered to disable oxytocin receptors lived long enough to implant into their mother’s placenta at much lower rates than normal embryos. This suggests that the ability to respond to oxytocin spikes and therefore go into diapause is somehow important for the developing pups’ survival, says Dr. Chao, who plans to examine this protective function in more detail.

“Despite being extremely common, infertility and developmental issues that can arise during pregnancy remain poorly understood and can have a lasting, devastating impact on parents and their children,” said study senior author Robert Froemke, PhD, professor of genetics. “Having a deeper understanding of the factors that contribute to these problems may allow experts to better address them in the future.”

The researchers next plan to examine how cell growth gets turned back on after diapause, Dr Froemke says. In addition, the team plans to explore how diapause may affect offsprings’ health and development after birth, and determine whether and how their discoveries can inform reproductive medicine.

Dr Froemke cautions that while the study results are promising, mice and humans have significant differences in their reproductive processes, despite both being mammals. He adds that the current investigation did not assess the role that other pregnancy-related hormones, such as oestrogen and progesterone, may play in diapause.

Source: NYU Langone Health / NYU Grossman School of Medicine

Categories : Exercise Obstetrics & GynaecologyTags :

Researchers Debunk Common Beliefs About ‘Cycle Syncing’ and Muscles

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New research from McMaster kinesiologists is challenging the internet belief that timing resistance training to specific phases of the menstrual cycle boosts the body’s ability to build muscle and strength.

The researchers have shown that exercising at various points in the cycle had no impact — positive or negative — on the synthesis of new muscle proteins, a process essential to building and maintaining muscle.

The results, published in the print edition of the Journal of Physiology, debunk the popularly touted practice of cycle syncing, or tailoring workouts to align with the way hormones change throughout a woman’s menstrual cycle.

“Our findings conflict with the popular notion that there is some kind of hormonal advantage to performing different exercises in each phase,” explains Lauren Colenso-Semple, lead author of the study and a former graduate student in the Department of Kinesiology, who conducted the work while at McMaster.

“We saw no differences, regardless of cycle timing.”

For the study, researchers monitored the menstrual cycles of participants — all healthy young women — for three months to confirm their cycles were normal. Contrary to popular belief, only a small percentage of women — about 12 per cent — have a consistent 28-day cycle and ovulate regularly on Day 14 or the “textbook” menstrual cycle.

Participants then ingested a tracer molecule, a benign substance designed to track and monitor muscle protein levels. They performed heavy resistance exercise during two distinct phases of their menstrual cycles: the follicular phase, when estrogen levels are at their peak; and the luteal phase, characterized by peak progesterone levels.

Researchers observed no effect of either menstrual cycle phase on the production of muscle proteins.

Cycle syncing has been made popular by internet influencers to coordinate workouts, certain diets and lifestyle behaviours with the menstrual cycle.

There are fitness apps for tracking cycles, and social media channels are rife with advice and recommendations.

Proponents routinely cite a handful of scientific studies on animals as evidence that fluctuations in ovarian hormones can affect how human muscles respond to exercise, but this study shows that not to be correct.

“Our work shows that women who want to lift weights and recondition their muscles should feel free to do so in any phase of their cycle. There is no physiological difference in response to the exercise,” says Stuart Phillips, the Canada Research Chair in Skeletal Muscle Health at McMaster who supervised the study.

“It is important to tailor your training to how you feel.”

Scientists highlight the need for further research, particularly studies that focus on women’s health. This includes investigating how training, in relation to the menstrual cycle, affects women and how both oral and non-oral contraceptives influence their responses to exercise.

This article was first published on Brighter World. Read the original article.

Categories : Ageing Obstetrics & GynaecologyTags :

Researchers Unravel Menopause Timing, Shedding Light on Ovarian Aging and Fertility

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Female reproductive system. Credit: Scientific Animations CC4.0 BY-SA

Menopause, driven by ovarian aging and the depletion of ovarian reserve, marks the end of a woman’s fertility, and while many aspects of these processes are well understood, the overall dynamics remain unclear. A new study from Rice University researchers, published in Biophysical Journal, introduces a novel approach to unravelling the complex patterns of ovarian aging using stochastic analysis, a mathematical approach that examines systems by evaluating all potential outcomes using random probability.

Led by Anatoly Kolomeisky, professor of chemistry and chemical and biomolecular engineering, the research team has developed a theoretical framework that quantitatively predicts menopause timing. By analysing how ovarian follicles transition through different stages, the researchers’ model explains why menopause occurs and sheds light on individual variability and cross-population differences. These insights could improve fertility planning, inform health care decisions related to hormonal therapies and enhance our understanding of age-related health risks associated with ovarian aging.

“By considering menopause as a sequential process involving random transitions of follicles, we can better understand individual variability and population-wide trends in menopause timing,” Kolomeisky said.

A new theoretical model unlocks the mystery of menopause

The research team hypothesised that ovarian aging follows a stochastic sequential process influenced by follicles transitioning through multiple developmental stages. Unlike previous studies focusing primarily on hormonal and genetic influences, this study employed explicit analytical calculations supported by extensive computer simulations.

The approach allowed researchers to model the gradual depletion of ovarian follicle reserves, providing a detailed quantitative framework that aligns with medical data from diverse populations.

“By applying stochastic analysis, we can move beyond broad observations and develop precise, predictive insights into menopause timing and variability,” Kolomeisky said.

Key findings uncover menopause timing

The researchers discovered a universal relationship between three critical factors: the initial follicle reserve, the rate of ovarian depletion and the threshold that triggers menopause. Their model also revealed that menopause occurs within a surprisingly narrow age range, a phenomenon that had not yet been fully explained.

“One of the most unexpected findings was the synchronisation of follicular transitions, which may regulate the timing of menopause,” Kolomeisky said. “This suggests that underlying biochemical processes ensure a relatively consistent age of menopause despite individual variations.”

Source: Rice University

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Ensuring Safe Motherhood: The Need for Quality Maternity Care

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As we observe Pregnancy Awareness Month this February, it is crucial to reflect on the journey of motherhood and the importance of comprehensive maternity care. According to the latest data from 2024, South Africa’s maternal mortality rate stands at approximately 119 deaths per 100 000 live births1. This statistic underscores the urgent need for improved maternity care services across the country.

Pregnancy is a transformative time, and the right support can make all the difference. From prenatal education to quality healthcare services, expectant mothers require tools and support to navigate this journey confidently. Focus must remain on education, enhancing maternity care services, and addressing the unique challenges faced by South African mothers to ensure that we promote healthy pregnancies and safe motherhood.

Empowering Mothers Through Education

“Education is the cornerstone of empowerment,” says Margot Brews, Head of Health Risk Management Strategy at Momentum Health. “By providing expectant mothers with accurate information about prenatal care, nutrition, and the stages of pregnancy, we can help them make informed decisions that benefit their health and the health of their babies.”

Margot Brews, Head of Health Risk Management Strategy at Momentum Health. Photo: Supplied.

Early antenatal care is crucial, as it allows for the early detection and management of potential complications such as hypertension, diabetes, and infections. In South Africa, where maternal and neonatal mortality rates remain a concern, education can be a powerful tool in reducing these numbers.

Enhancing Maternity Care Services

Quality maternity care is essential for ensuring safe pregnancies and healthy births. In South Africa, access to quality healthcare services can be disparate, with rural areas often facing significant challenges.

“Maternity care is critically important as it directly impacts the health and well-being of both mothers and their babies,” Brews emphasises. “Comprehensive maternity care includes not only medical care but also emotional and psychological support for expectant mothers.”

Early and regular antenatal visits are crucial for detecting and managing potential complications, such as hypertension, diabetes, and infections. Additionally, providing mental health support as part of maternity care can help address anxiety and depression, which are common during pregnancy and postpartum.

Efforts to enhance maternity care services must focus on improving infrastructure in healthcare facilities, training healthcare providers, and ensuring the availability of essential medicines and equipment. “By addressing these challenges, we can create a supportive environment that promotes healthy pregnancies and safe motherhood for all women in South Africa,” Brews adds.

Addressing the Challenges Faced by Mothers

South African mothers face a range of challenges, from financial constraints to social stigma. Teenage pregnancies, in particular, pose significant risks to both the mother and the child. Additionally, teenage mothers often face barriers to continuing their education, which can impact their long-term economic prospects.

“To address these challenges, we must create supportive environments which encourage young mothers to seek prenatal care and continue their education. This should start before pregnancy in the form of guidance and support within the context of broader sexual reproductive health. Community-based programs that provide childcare support, financial assistance, and educational opportunities can make a significant difference in the lives of young mothers and their children,” says Brews.

The Role of Partners and Families

Pregnancy is not only a journey for the mother; it involves the entire family. Partners and families play a crucial role in providing support and creating a nurturing environment for the expectant mother. This involvement can help strengthen the family unit and ensure that the mother receives the emotional and practical support she needs.

“Partners and families are integral to the pregnancy journey, specifically within the cultural context of South Africa,” Brews notes. “Their support can make a significant difference in the emotional and physical well-being of the expectant mother.”

Promoting Maternal Mental Health

Mental health is a critical aspect of maternity care that is often overlooked. Pregnancy and childbirth can be emotionally challenging, and many women experience anxiety, depression, or other mental health strains during this time. It is essential to provide mental health support as part of comprehensive maternity care.

“February presents an opportunity to reflect on the importance of empowering mothers and enhancing maternity care in South Africa,” says Brews. “By working together, we can ensure that every mother has the resources and support she needs for a healthy and positive pregnancy journey.”

Momentum Health believes that by prioritising maternity care, a significant difference can be made in the lives of mothers and their babies. Education and advocating for quality maternity care for all is critical and more must be done to improve maternal care, address disparities in healthcare access, and provide comprehensive support to expectant mothers and mothers in general. “Together, we can make a significant difference in the lives of mothers and their babies, creating a healthier and brighter future,” concludes Brews.

Categories : Cancer Obstetrics & GynaecologyTags :

A Short Course of Radiation Therapy for Endometrial Cancer Patients is Effective

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Female reproductive system. Credit: Scientific Animations CC4.0 BY-SA

In a randomised clinical trial, researchers from Huntsman Cancer Institute at the University of Utah (the U) have found that short-course, higher dose vaginal brachytherapy for endometrial cancer had similar effectiveness to more frequent, lower dose sessions.

Gita Suneja, MD, MS, physician-scientist at Huntsman Cancer Institute and professor of radiation oncology at the U, is the first author of the SAVE trial report – which stands for, Short-Course Adjuvant Vaginal Cuff Brachytherapy in Early Endometrial Cancer Compared with Standard of Care.

“There isn’t high quality-data on optimal dose and schedule for brachytherapy treatments. Because of this, practice patterns really vary,” says Suneja. “The SAVE trial sought to try to lower the number of treatments that patients were receiving but maintain short-term quality of life and disease control.”

Endometrial cancer is a disease that begins in the lining of the uterus. The primary treatment for endometrial cancer is surgery, including the removal of the uterus, cervix, and upper vagina. Brachytherapy, a form of internal radiation, is used as a secondary treatment to prevent the cancer’s return. Patients receiving vaginal cuff brachytherapy are treated with internal radiation by way of an applicator in the vaginal cavity.

The SAVE trial compared two groups who received different treatment doses over a varying number of sessions. The control group received the standard treatment – between three to five appointments with lower doses. The experimental group received higher doses of radiation in just two sessions.

“The study outcomes will help improve cancer care for Huntsman Cancer Institute patients across the five states of the Mountain West.”

Gita Suneja, MD, MS

The researchers found similarly effective short-term outcomes and few acute toxicities for the patients in the experimental group.

David Gaffney, MD, PhD, FACR, FABS, FASTRO, physician-scientist at Huntsman Cancer Institute and professor of radiation oncology at the U, developed the idea for the SAVE study after seeing patient need. According to the American Cancer Society, endometrial cancer is the most common cancer of the female reproductive organs. Incidence is on the rise, as is the mortality rate.

“It is a big win when we can preserve good outcomes and make cancer care easier,” says Gaffney.

The results of the SAVE trial were published in JCO Oncology Advances.

Source: Huntsman Cancer Institute

Categories : Cardiovascular Disease Obstetrics & GynaecologyTags :

Study Probes How to Predict Complications from Preeclampsia

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Data from 8843 women diagnosed with preeclampsia during pregnancy showed that existing risk prediction models are most accurate only in the days after diagnosis

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The existing prediction models for severe complications of preeclampsia are most accurate only in the two days after hospital admission, with deteriorating performance over time, according to a new study published February 4th in the open-access journal PLOS Medicine by Henk Groen of University of Groningen, the Netherlands, and colleagues.

Preeclampsia is a potentially life-threatening condition that can occur during pregnancy; of women diagnosed with preeclampsia, 5-20% will develop severe complications. Two existing PIERS (Pre-eclampsia Integrated Estimate of RiSk) models, PIERS Machine Learning (PIERS-ML) and the logistic-regression-based fullPIERS, are designed to identify individuals at greatest or least risk of adverse maternal outcomes in the 48 hours following hospital admission for preeclampsia. However, both models are regularly used for ongoing assessment beyond the first 48 hours.

In the new study, researchers used data from 8843 women diagnosed with preeclampsia at a median gestational age of 36 weeks between 2003 and 2016. Data included PIERS-ML and fullPIERS assessments as well as health outcomes.

The study found that neither the PIERS-ML nor fullPIERS model maintained good performance over time for repeated risk stratification in women with preeclampsia. The PIERS-ML remained generally good at identifying the very high-risk and very-low risk groups over time, but performance of the larger high-risk and low-risk groups deteriorated significantly after 48 hours. The fullPIERS model underperformed compared to the PIERS-ML model.

“Since there are no better options, clinicians may still use these two models for ongoing assessments after the first admission with pre-eclampsia, but the predictions should be treated with increasing caution as the pregnancy progresses,” the authors say. More prediction models are needed that perform well over time, they add.

The authors add, “Pregnancy hypertension outcome prediction models were designed and validated for initial assessment of risks for mothers; this study shows that such ‘static’ models if used repeatedly over days yield increasingly inaccurate predictions.”

Provided by PLOS

Categories : Cancer Obstetrics & GynaecologyTags :

Could the Contraceptive Pill Reduce the Risk of Ovarian Cancer?

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It’s a little pill with big responsibilities. But despite its primary role to prevent pregnancy, the contraceptive pill (or ‘the Pill’) could also help reduce the risk of ovarian cancer, according to new research from the University of South Australia.

Screening for risk factors of ovarian cancer using artificial intelligence, UniSA researchers found that the oral contraceptive pill reduced the risk of ovarian cancer by 26% among women who had ever used the Pill, and by 43% for women who had used the Pill after the age of 45.

The study, published in the International Journal of Gynecologic Cancer, also identified some biomarkers associated with ovarian cancer risk, including several characteristics of red blood cells and certain liver enzymes in the blood, with lower body weight and shorter stature associating with a lower risk of ovarian cancer.

Researchers also found that women who had given birth to two or more children had a 39% reduced risk of developing ovarian cancer compared to those who had not had children.

UniSA researcher Dr Amanda Lumsden says understanding risks and preventative factors for ovarian cancer is key for improved treatment and outcomes.

“Ovarian cancer is notoriously diagnosed at a late stage, with about 70% of cases only identified when they are significantly advanced,” Dr Lumsden says.

“Late detection contributes to a survival rate of less than 30% over five years, in comparison to more than 90% for ovarian cancers that are caught early. That’s why it’s so important to identify risk factors.

“In this research, we found that women who had used the oral contraceptive pill had a lower risk of ovarian cancer. And those who had last used the Pill in their mid-40s, had an even lower level of risk.

“This poses the question as to whether interventions that reduce the number of ovulations could be used as a potential target for prevention strategies for ovarian cancer.”

Supported by the MRFF, the study used artificial intelligence to assess the data of 221 732 females (aged 37-73 at baseline) in the UK Biobank.

Machine learning specialist, UniSA’s Dr Iqbal Madakkatel, says the study shows how AI can help to identify risk factors that may otherwise have gone undetected.

“We included information from almost 3000 diverse characteristics related to health, medication use, diet and lifestyle, physical measures, metabolic, and hormonal factors, each measured at the start of the study,” Dr Madakkatel says.

Source: University of South Australia

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Music Can Influence Foetal Heart Rate in the Womb

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Playing music has long been a way for expectant parents to connect with their children in the womb, but a group of researchers has found evidence it can calm foetal heart rates, potentially providing developmental benefits.

In the interdisciplinary journal Chaos, researchers studied the effect of classical music on a foetal heartbeat. The team used mathematical analysis tools to identify patterns in heart rate variability.

Typical measures of heart rate are an average of several beats across multiple seconds. In contrast, heart rate variability measures the time between individual beats. This measure can provide insight into the maturation of the foetal autonomic nervous system, with greater variability often indicating healthy development.

To test the effects music can have on foetal heart rate, the group of researchers recruited 36 pregnant women and played a pair of classical pieces for their foetuses. For the experiment, they chose “The Swan,” by French composer Camille Saint-Saëns, and “Arpa de Oro,” by Mexican composer Abundio Martínez.

By attaching external heart rate monitors, the researchers could measure the foetal heart rate response to both songs. And by employing nonlinear recurrence quantification analysis, they could identify changes in heart rate variability during and after the music was played.

“Overall, we discovered that exposure to music resulted in more stable and predictable foetal heart rate patterns,” said author Claudia Lerma. “We speculate that this momentary effect could stimulate the development of the foetal autonomic nervous system.”

In addition to the overall effects of playing music, the researchers looked at the differences between the two classical pieces. While both were effective, they found that the Mexican guitar melody had a stronger effect.

“When contrasting ‘The Swan’ with ‘Arpa de Oro,’ we did notice some significant differences,” said author Eric Alonso Abarca-Castro. “In particular, the second piece appeared to have a stronger impact on some measures, indicating that it produced heart rate patterns that were more predictable and regular. Factors like rhythmic characteristics, melodic structure, or cultural familiarity may be linked to this differentiation.”

For expectant parents at home, the researchers suggest that classical music could help promote fetal development.

“Our results suggest that these changes in foetal heart rate dynamics occur instantly in short-term fluctuations, so parents might want to consider exposing their foetuses to quiet music,” said Abarca-Castro. “Parents who play soothing music may stimulate and benefit the foetal autonomic system.”

The authors plan to continue to explore this effect, looking at different genres and types of music to further their understanding.

“To ascertain whether rhythmic or cultural variations elicit distinct foetal cardiac responses, we intend to increase the size of our sample and expand our investigation to include a variety of musical styles beyond classical pieces,” said author José Javier Reyes-Lagos.

Source: American Institute of Physics

Categories : Diet and Nutrition Obstetrics & GynaecologyTags :

The Importance of Vitamin D during First Trimester

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Low vitamin D levels in the first trimester of pregnancy are associated with higher rates of preterm birth and decreased foetal length, according to a new study led by researchers in the Penn State Department of Nutritional Sciences. This research provides evidence that early pregnancy or even preconception may represent critical time points for intervening with women who have low vitamin D status, to optimise pregnancy outcomes.

Celeste Beck, who earned her doctorate in nutritional sciences from Penn State in 2023, and Alison Gernand, Beck’s doctoral adviser and associate professor of nutritional sciences at Penn State, led the study. Their results were recently published in The American Journal of Clinical Nutrition.

“More than 25% of women who are pregnant or lactating have lower than recommended levels of vitamin D,” Gernand said, explaining that prior research has demonstrated the effect of vitamin D on foetal skeletal growth, maternal immune function at the foetal interface, and the development of the placenta in pregnant women. “A lot of the development early in pregnancy requires vitamin D, so we conducted this study to better understand how early-pregnancy vitamin D status is related to pregnancy outcomes.”

Most prior studies on vitamin D status in pregnant women have measured vitamin D concentrations starting in the second trimester or later, the researchers said. The researchers said this study, to their knowledge, is the first to examine both first and second trimester maternal vitamin D status in relation to longitudinal foetal growth and pregnancy outcomes.

The researchers at Penn State partnered with colleagues at the University of Utah to test blood samples from 351 women collected as part of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be, which was funded by the National Institute of Child Health and Human Development and recruited pregnant women across the United States between 2010 and 2013.

According to the Institute of Medicine, less than 50nmol/L represents an insufficiency of vitamin D. When the researchers compared outcomes for women with vitamin D insufficiency (less than 50nmol/L) to women with sufficient vitamin D (more than or equal to 50nmol/L), they found no statistical differences in pregnancy outcomes. However, when the researchers compared pregnancy outcomes across a wider range of vitamin D concentrations, they found that pregnant women with first trimester vitamin D concentrations lower than 40 nmol/L were four times more likely to experience a preterm birth compared to women with vitamin D concentrations more than or equal to 80nmol/L.

Despite the higher risk of preterm birth in women with low vitamin D status, the researchers cautioned that these results were based on a very low number of preterm births in this study and recommend that additional, larger studies be conducted.

The researchers also observed an association between first-trimester vitamin D concentrations and certain foetal growth patterns. Women with higher levels of vitamin D experienced a small but statistically significant increase in foetal length.

Source: Penn State