As a research scientist with a decade of experience studying the role of creatine in maternal and child health, Dr Stacey Ellery is well qualified to discuss creatine and pregnancy. As a mother she also has a personal perspective on creatine and pregnancy.
Her research program includes international teams of clinicians, biomedical scientists, neuroscientists and analytical chemists in Australia, New Zealand and the United States. They are investigating many aspects of the role creatine may play in producing healthy mothers and babies.
What is creatine?
Creatine is a compound found naturally in foods derived from animal protein, mainly meat, fish and dairy.
Creatine is used by many cells in your body to help produce energy. It fuels the processes that provide immediate energy to cells when demands rise quickly. That is why for more than 20 years many elite and amateur athletes have used dietary creatine supplements to aid in muscle performance. Creatine supplements are also being assessed to support neurological health in those with Parkinson’s disease, major depressive disorders and even to help with fatigue.
Why do some people take creatine before or during pregnancy?
Many people are now taking creatine before pregnancy and then choosing to maintain their supplement use while pregnant. Indeed, we have anecdotal evidence to this effect. Some research has shown that supplementing the mother’s diet during pregnancy improved the likelihood of having a healthy baby at birth, suggesting that a creatine nutritional supplement could be beneficial for a healthy pregnancy and baby.
Is there any evidence of benefits for mother or baby?
There is growing evidence that creatine may be essential for energy production in a range of reproductive tissues, from sperm and the endometrium to the placenta, the muscle layer of the uterus (the myometrium) crucial to labour, as well as for the growing and developing baby.
There is also evidence that increasing fetal levels of creatine before birth via maternal dietary supplements may help minimise injury to the baby when there are complications during labour that reduce oxygen delivery to the unborn baby. This research has focused on protecting the newborn brain and reducing the risk of lifelong conditions such as cerebral palsy.
How safe is it to take creatine during pregnancy?
Given the benefits for mother and baby, Dr Stacey Ellery and her team are investigating the optimal level of creatine during pregnancy, including creatine supplementation. This is the first safety study of creatine conducted in human pregnancy.
The team recently examined all available literature for non-pregnant women (known as a systematic review and meta-analysis). They studied the data from 951 females aged from 16 to 67 years who were treated with creatine for up to a year in clinical trial settings and found no evidence of death or serious adverse events due to creatine. Nor was there an increase in milder side effects, such as an upset stomach.
Understanding the importance of establishing safety for a vulnerable population like pregnant women, the team has also gone to efforts to assess the mother’s and offspring’s wellbeing from more than 15 years of data in pre-clinical studies to show no adverse effects of supplementing the mother’s diet with creatine during pregnancy.
Are there side effects from taking creatine during pregnancy?
None that we are currently aware of in human pregnancy, or that we have detected through our extensive animal studies. As creatine is naturally found in our diet, if we choose to consume animal products, and is produced by the body itself, creatine is very well tolerated. Any excess creatine appears to be successfully eliminated by our kidneys without causing problems.
What is a safe dosage of creatine during pregnancy?
A study is currently underway in third trimester pregnant women being cared for at Monash Health to understand precisely the best dose of creatine in pregnancy. They are trialling amounts routinely used for exercise performance, mainly five grams of creatine daily. These studies and the mathematical modelling should be completed during 2023.
Can creatine help or hinder conception?
The role of creatine in conception is an exciting new area of research. We have known for many years that sperm use creatine to produce energy during critical stages of fertilisation. There is emerging evidence that the endometrial layer of the uterus uses creatine to produce energy during the phase of the reproductive cycle when a fertilised egg implants to commence pregnancy. Of importance, it appears as though creatine storage and production of creatine by the endometrium may be altered in women having trouble conceiving. Further studies are required, but the simple addition of dietary creatine supplements may benefit both men and women trying to conceive.
As a new mother, what was your approach to creatine during pregnancy? Any recommendations/advice for people who are planning a pregnancy or already pregnant?
I have been studying creatine in pregnancy for many years now. Around the time of planning to start my own family, I was working on data that suggested creatine may be important for the uterus around the time of embryo implantation. I was also spending much of my time complying data from over 250 pregnant women which suggests the body goes to great lengths to ensure an adequate supply of creatine to the developing fetus is maintained during pregnancy.
I was therefore met with quite the dilemma, should I be taking creatine? I was comfortable with the safety data available but was also aware that we still have a way to go to understand the full picture of the importance of creatine in pregnancy. So, in consultation with my obstetrician, I chose to take a creatine supplement (5 grams) a couple of times a week. I wasn’t religious about it. I just dropped in a scoop every time a made myself a fruit smoothie or protein shake. I also tried to eat creatine-rich foods, mainly fish and red meat, a couple of times a week.
I was fortunate to conceive relatively quickly and had a very straightforward pregnancy. Despite the perfect pregnancy there was a period towards the end of my labour when my son wasn’t doing so well. He was a little stuck and his heart rate was dropping with each contraction (a sign that his oxygen flow wasn’t quite high enough). The brilliant team at Monash were able to deliver him quickly and he was fine. Did the creatine help in my situation? As a scientist I know there is absolutely no way to tell. But the experience definitely cemented my resolve to find out, through continuing our research.
Where does your research go from here?
Our focus is on identifying the benefits creatine could bring, on several fronts.
We are finalising our pre-clinical studies on whether increased fetal creatine reserves, achieved through mothers taking supplements during pregnancy, can protect the newborn brain from complications around the time of birth which limit oxygen delivery to the fetus.
We are also exploring whether creatine may be an essential nutritional supplement for babies born preterm, a group particularly vulnerable to brain injuries around birth. Finally, we are seeking funding to ramp up research on the importance of creatine for prospective mums and dads around the time of conception. There is a rationale for creatine aiding in the energy production of reproductive tissues for both natural pregnancies and in the context of IVF. Still, this area remains largely unexplored to date.
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