Creatine is a compound naturally present in muscle cells, helping them generate energy for high-intensity activities. The body produces some creatine, and it is also obtained from protein-rich foods like red meat and fish. This article explores the current understanding of creatine use during pregnancy, examining its physiological role, potential advantages, safety considerations, and the direction of ongoing research.
Creatine’s Role in Pregnancy Physiology
Creatine functions in the body by helping to create a steady supply of energy, particularly in tissues with high energy demands such as muscle and brain. It facilitates the recycling of adenosine triphosphate (ATP), the body’s primary energy currency, by converting adenosine diphosphate (ADP) back to ATP. About 95% of the body’s creatine is stored in muscles as phosphocreatine, a form of stored energy.
Pregnancy presents unique physiological demands, with increased energy requirements for both the mother and the developing fetus. Creatine metabolism helps maintain intracellular ATP production, supporting these heightened energy needs.
Increased creatine transporter messenger RNA expression has been observed in maternal tissues with high-energy demands, such as the heart and skeletal muscle, during the third trimester. The placenta, a metabolically active organ, also has a creatine requirement, and its creatine kinase expression peaks at term. This suggests an adaptive mechanism to ensure creatine is available where energy expenditure is high, supporting both maternal tissues and fetal development.
Potential Advantages for Mother and Infant
Preliminary research and animal studies suggest potential benefits of creatine supplementation during pregnancy, primarily linked to its role in energy production and cellular protection. Creatine may support fetal brain and organ development. Increasing fetal creatine levels before birth through maternal supplementation could help minimize injury if the baby experiences reduced oxygen delivery during labor. This neuroprotective effect has been observed in animal models, where creatine appeared to help the brain recover and minimize damage from oxygen deprivation.
Creatine may also support maternal energy levels. Creatine has been identified for its antioxidant actions and its ability to stabilize lipid membranes, which could be beneficial in pregnancy where there is increased generation of oxygen and nitrogen free radicals.
While direct human trials are limited, some studies propose that creatine supplementation during pregnancy may benefit the fetus and neonate when oxidative stress or feto-placental hypoxia occurs, such as in cases of fetal growth restriction, premature birth, or complicated labor.
Safety Concerns and Precautions
The primary concern regarding creatine supplementation during pregnancy is the limited number of extensive, well-controlled human clinical trials. While preclinical data suggest creatine supports maternal and fetal energy homeostasis, its use in human pregnancy remains largely unexplored. This lack of sufficient evidence of safety and efficacy leads to a cautious approach from health organizations.
In non-pregnant populations, some side effects of creatine supplementation have been noted, though generally considered mild. These include weight gain, often due to water retention, and occasional gastrointestinal issues such as nausea, vomiting, or diarrhea. A single dose of 10 grams of creatine has been linked to an increased risk of diarrhea, whereas smaller doses of 2 to 5 grams typically do not report these side effects.
While creatine can slightly elevate creatinine levels in the blood, a marker often used for kidney function, this elevation does not necessarily indicate kidney damage in healthy individuals. For pregnant individuals, the lack of specific safety data means a cautious approach is warranted. The supplement industry also lacks tight regulation, so the purity and potential interactions of creatine products with other nutrients or medications are not always guaranteed.
Current Guidance and Research Outlook
Medical professionals generally advise against routine creatine supplementation during pregnancy due to the lack of sufficient large-scale, high-quality human studies demonstrating its safety and benefits. While animal studies have suggested a neuroprotective role for creatine in the fetus, no completed or ongoing randomized controlled trials in humans have been identified to assess this. Therefore, medical supervision is recommended for any supplement use during pregnancy.
Ongoing research efforts and clinical trials are designed to better understand creatine’s safety and efficacy in pregnant women. Researchers are also exploring whether creatine could be a beneficial nutritional supplement for preterm babies, who are particularly susceptible to brain injuries.
Consulting a healthcare provider before taking any supplements during pregnancy is important. Discussions with an obstetrician or physician can help determine if creatine is appropriate based on individual health status and pre-existing conditions. Future research aims to clarify whether low creatine concentrations in pregnancy are linked to poorer outcomes and to further explore creatine’s potential to improve reproductive health and perinatal outcomes.