Creatine and pregnancy outcomes, a prospective cohort study in low-risk pregnant women: study protocol

Abstract

IntroductionThe creatine kinase circuit is central to the regulation of high-energy phosphate metabolism and the maintenance of cellular energy turnover. This circuit is fuelled by creatine, an amino acid derivative that can be obtained from a diet containing animal products, and by synthesis in the body de novo. A recent retrospective study conducted in a cohort of 287 pregnant women determined that maternal excreted levels of creatine may be associated with fetal growth. This prospective study aims to overcome some of the limitations associated with the previous study and thoroughly characterise creatine homeostasis throughout gestation in a low-risk pregnant population.Methods and analysisThis study is recruiting women with a singleton low-risk pregnancy who are attending Monash Health, in Melbourne, Australia. Maternal blood and urine samples, along with dietary surveys, are collected at five time points during pregnancy and then at delivery. Cord blood and placenta (including membranes and cord) are collected at birth. A biobank of tissue samples for future research is being established. Primary outcome measures will include creatine, creatine kinase and associated metabolites in antenatal bloods and urine, cord bloods and placenta, along with molecular analysis of the creatine transporter (SLC6A8) and synthesising enzymes L - arginine:glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT) in placental tissues. Secondary outcome measures include dietary protein intake over pregnancy and any associations with maternal creatine, pregnancy events and birth outcomes.Ethics and disseminationEthical approval was granted in August 2015 from Monash Health (Ref: 14140B) and Monash University (Ref: 7785). Study outcomes will be disseminated at international conferences and published in peer-reviewed scientific journals.Trial registration numberACTRN12618001558213; Pre-results.

Daidzein Supplementation Enhances Embryos Survival by Improving Hormones, Antioxidant Capacity, and Metabolic Profiles of Amniotic Fluid in Sows

“…Creatine also has the potential to improve the survival and growth of embryos. Previous studies have reported that maternal dietary creatine supplementation during gestation could improve pregnancy outcomes [57]. Therefore, the improved embryo growth and development due to Daidzein supplementation occurs may as a result of changes in the concentrations of Arginine and Creatine.…”

Relationships between Total, Free and Bioavailable Vitamin D and Vitamin D Binding Protein in Early Pregnancy with Neonatal Outcomes: A Retrospective Cohort Study

“…The second population was derived from the Creatine and Pregnancy Outcomes (CPO) study, which aimed to characterise creatine homeostasis in pregnancy in a low-risk pregnancy group [ 29 ]. This cohort was also recruited in early pregnancy (<20 weeks gestation) from Monash Health, for a prospective observational study aimed at characterising creatine homeostasis in low-risk pregnancies [ 29 ].…”

“…The second population was derived from the Creatine and Pregnancy Outcomes (CPO) study, which aimed to characterise creatine homeostasis in pregnancy in a low-risk pregnancy group [ 29 ]. This cohort was also recruited in early pregnancy (<20 weeks gestation) from Monash Health, for a prospective observational study aimed at characterising creatine homeostasis in low-risk pregnancies [ 29 ]. There was no exclusion by BMI, but participants with significant medical or obstetric history or with primary models of care outside tertiary public hospital care (e.g., private, shared, or GP/midwife care) were excluded, as were women who used creatine supplements (since the original CPO study focused on creatine in pregnancy).…”

Early Pregnancy Vitamin D Binding Protein Is Independently Associated with the Development of Gestational Diabetes: A Retrospective Cohort Study

“…The second population, the creatine and pregnancy outcomes (CPO) cohort, were a low risk pregnancy group (participants with significant medical or obstetric history were excluded; Table 1). This cohort was recruited in early pregnancy (<20 weeks gestation), also from Monash Health, for a prospective observational study aimed at characterising creatine homeostasis in low-risk pregnancies [20]. The CPO low-risk pregnancy cohort recruited 282 pregnant women, of which 18 subsequently withdrew or were excluded, and 264 remained involved until the study conclusion.…”