Higher Plasma Myo-Inositol in Pregnancy Associated with Reduced Postpartum Blood Loss: Secondary Analyses of the NiPPeR Trial

Higher Plasma Myo-Inositol in Pregnancy Associated with Reduced Postpartum Blood Loss: Secondary Analyses of the NiPPeR Trial

Nutrients

10.3390/nu16132054

https://doi.org/10.3390/nu16132054

Hsin F. Chang, Hannah E. J. Yong, Han Zhang, Jui-Tsung Wong, Sheila J. Barton, Philip Titcombe, Benjamin B. Albert, Sarah El-Heis, Heidi Nield, Judith Ong, Luca Lavelle, J. Manuel Ramos-Nieves, Jean-Philippe Godin, Irma Silva-Zolezzi, Wayne S. Cutfield, Keith M. Godfrey, Shiao-Yng Chan,

placenta, myo-inositol, postpartum haemorrhage, vitamins, micronutrients

28 June 2024

Chang, H. F., Yong, H. E. J., Zhang, H., Wong, J.-T., Barton, S. J., Titcombe, P., Albert, B. B., El-Heis, S., Nield, H., Ong, J., Lavelle, L., Ramos-Nieves, J. M., Godin, J.-P., Silva-Zolezzi, I., Cutfield, W. S., Godfrey, K. M., Chan, S.-Y., & the NiPPeR Study Group. (2024). Higher Plasma Myo-Inositol in Pregnancy Associated with Reduced Postpartum Blood Loss: Secondary Analyses of the NiPPeR Trial. Nutrients, 16(13), 2054. https://doi.org/10.3390/nu16132054

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.

Attribution 4.0 International (CC BY 4.0)

Public good funding for this investigator-led study is through the UK Medical Research Council (as part of an MRC award to the MRC Lifecourse Epidemiology Unit (MC_UU_12011/4)); the Singapore National Research Foundation, National Medical Research Council (NMRC, NMRC/TCR/012-NUHS/2014); the National University of Singapore (NUS) and the Agency of Science, Technology and Research (as part of the Growth, Development and Metabolism Programme of the Singapore Institute for Clinical Sciences (SICS) (H17/01/a0/005); and as part of Gravida, a New Zealand Government Centre of Research Excellence. Funding for the provision of the intervention and control drinks and to cover aspects of the fieldwork for the study has been provided by Société Des Produits Nestlé S.A under a Research Agreement with the University of Southampton, Auckland UniServices Ltd., SICS, National University Hospital Singapore PTE Ltd. and NUS. KMG is supported by the National Institute for Health Research (NIHR Senior Investigator (NF-SI-0515- 10042), NIHR Southampton 1000DaysPlus Global Nutrition Research Group (17/63/154), and NIHR Southampton Biomedical Research Center (IS-BRC-1215-20004)), British Heart Foundation (RG/15/17/3174) and the European Union (Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1- DE-EPPKA2-CBHE-JP). SYC is supported by a Singapore NMRC Clinician Scientist Award (NMRC/CSA-INV/0010/2016; MOH-CSAINV19nov-0002).

https://oar.a-star.edu.sg/communities-collections/articles/21981

2072-6643

Institute for Human Development and Potential

https://doi.org/10.3390/nu16132054