Metro Vancouver Study finds an association between South Asian Ethnicity and Risk of Vitamin B12 Deficiency during Pregnancy

Vitamin B12 (B12) sufficiency during pregnancy is essential for optimal maternal health and fetal and infant growth and development. Maternal B12 deficiency has been associated with poor pregnancy outcomes, such as preterm birth, low birth weight, intra-uterine growth restriction and neural tube defects, as well as poor cardiometabolic health and impaired cognitive development in the infant. Suboptimal B12 status has previously been reported in pregnant Canadian women. A secondary analysis study conducted by the research team of Dr Yvonne Lamers, Canada Research Chair in Human Nutrition and Vitamin Metabolism, aimed to determine B12 status and the prevalence of B12 deficiency in pregnant women in Metro Vancouver, using the more sensitive, combined measurement of a direct (plasma total B12) and functional (methylmalonic acid (MMA)) B12 indicator. The sample of the original cross-sectional study included 320 women with singleton pregnancies between their 20th and 35th weeks of gestation, with data collection between February 2009 and February 2010.

The prevalence of plasma total B12 concentration below 148pmol/L (reflecting B12 deficiency) and of concentrations between 148-220pmol/L (reflecting suboptimal B12 status) were 18% and 33%, respectively, in these 320 pregnant women of European, Chinese Asian, South Asian or other ethnicities. South Asian ethnicity was the strongest predictor of having plasma total B12 concentration reflecting B12 deficiency, with South Asian pregnant women having a 10x greater risk of B12 deficiency compared to European pregnant women. The odds of having elevated MMA concentrations (>220pmol/L) was 5x higher in South Asian compared to European pregnant women. Conversely, B12 supplement use decreased the risk of B12 deficiency by 69% in all pregnant women. A higher prevalence of B12 deficiency in South Asian pregnant women may be due to lower intake of animal source foods, the natural sources of dietary B12. Future research is underway to investigate the predictors of low B12 status in South Asian pregnant women. Overall, the study highlights the importance of determining B12 status early in pregnancy to allow for early intervention to prevent adverse maternal and fetal health outcomes.

Read the full study here.

PHENYLALANINE-REQ-PREGNANCY

Determining Dietary Phenylalanine Requirements during Different Stages of Gestation in Healthy Pregnant Women

Principal Investigator: Dr. Rajavel Elango

Primary Contact: Madeleine Ennis, Graduate Student, 604-875-2000 x 4607

About the study: PHENYLALANINE-REQ-PREGNANCY is trying to determine the amount of dietary phenylalanine required by women during pregnancy to ensure healthy development of their baby.  Pregnancy is a critical time that necessitates sufficient nutrition to ensure healthy development of both the mother and the baby.  Amino acids such as phenylalanine are the building blocks of protein, which are used to create body tissue and support the immune system.  Phenylalanine must be obtained through the diet, and the requirements during pregnancy are not currently determined. Inadequate protein and amino acid consumption during pregnancy has been linked to future risk of high blood pressure, heart disease, and other metabolic problems in the baby.  Therefore, it is important to determine how much phenylalanine should be consumed during pregnancy.

Study status: Recruiting

Who can participate:

Women who are:
 20-40 years of age
 pregnant with a single child
 between 13-19 weeks of gestation or 33-39 weeks of gestation
 free of chronic diseases/acute diseases, and have a full range of physical mobility

Co-Investigator: Dr. Ken Lim

Funded by: Canadian Institutes of Health Research

Consent Form: consent-form-for-participant

Impact of Timing of Surgical Management After Detection of Early Pregnancy Loss on Women’s Emotional Health study

Impact of Timing of Surgical Management After Detection of Early Pregnancy Loss on Women’s Emotional Health study

Principal Investigator: Dr. Stephanie Fisher

Primary Contact: Emma Branch, Research Assistant, WHRI, 604-875-2424 ext 4796, Emma.Branch@cw.bc.ca 

About the study: We want to explore how the timing of having a dilatation and curettage (D&C) procedure for a miscarriage impacts a women’s emotional well-being. Dilatation and curettage (D&C) is a minor surgical procedure in which the cervix is gently opened (dilation) and the pregnancy is removed with a suction device or small curette (curettage). D&C is performed to clear the uterine lining after a miscarriage. This study is qualitative and exploratory. Women taking part in this study will be asked to participate in an interview. In addition, we will collect information about the D&C procedure and some demographic data.

Why is this research important? We hope that the findings in this study can be used to improve counseling for women who choose to undergo a D&C procedure for their early pregnancy loss (less than 12 weeks and 6 days).

Study status: Recruiting

Who can participate: We want to hear from women who had a D&C procedure within 36 hours of their visit to the Early Pregnancy Assessment Clinic (EPAC) and from women who had a D&C procedure after 36 hours of their visit to EPAC.

Co-Investigators: Mariana Veiga, Caitlin Johnston, Dr. Stephanie Rhone, Edwina Houlihan.

Funded by: BC Women’s Hospital Nursing Research Grant

Immunization of Women with Diphtheria and Tetanus Toxoids Combined with Acellular Pertussis (Tdap) During the Mid Third Trimester of Pregnancy: An Evaluation of the Potential for Immunological Protection for the Neonate

Immunization of Women with Diphtheria and Tetanus Toxoids Combined with Acellular Pertussis (Tdap) During the Mid Third Trimester of Pregnancy: An Evaluation of the Potential for Immunological Protection for the Neonate

Principal Investigator: Dr. Scott Halperin (Global PI), Dr. Deborah Money (Local PI).

Primary Contact: Nancy Lipsky, Research Manager, nlipsky@cw.bc.ca, 604-875-2424 Ext. 4877

About the study: This study involves vaccinating pregnant women with the pertussis (also known as “whooping cough”) vaccine.  Pertussis is a highly transmissible bacterial respiratory infection caused by the bacteria Bordetella pertussis, the classical symptom of which is a serious cough that can last many weeks. The purpose of this study is to see if the vaccine antibodies (protection) are transferred from mother to baby through the placenta and breast milk in high enough levels to provide protection to the newborn baby if the mother receives the pertussis vaccine during the mid third trimester of pregnancy.  We are also looking to see if vaccinating the mother will affect the baby’s protection levels once the baby starts receiving his/her routine infant vaccine.

Why is this research important?  In Canada, there are 1–3 deaths each year from whooping cough; all have been in infants too young to have begun their immunization series.  We are investigating maternal vaccination during the third trimester of pregnancy in an effort to better understand how we can protect young infants from pertussis and prevent related infant harm and deaths.

Study Status: Data analysis

Co-Investigators: Beth Halperin, Victoria Allen, Joanne Langley, Shelly McNeil, Bruce Tapiero, Marc Boucher, Nicole LeSaux, Andree Gruslin, Dat Tran, Mark Yudin, Otto Vanderkooi, Doug Wilson, Wendy Vaudry, Sue Chandra, Simon Dobson, Deborah Money.

A PILOT STUDY TO DETERMINE THE OPTIMAL FINGER FOR HYPERTENSION AND PREECLAMPSIA ASSESSMENT USING PULSE OXIMETER COLLECTION

A PILOT STUDY TO DETERMINE THE OPTIMAL FINGER FOR HYPERTENSION AND PREECLAMPSIA ASSESSMENT USING PULSE OXIMETER COLLECTION

Principal Investigator: Dr. Kenneth I. Lim

Primary Contact: Dr. Mohamed Elgendi, Mining for Miracles Postdoctoral Fellow, 604-875-2723 Email: mohamed.elgendi@cw.bc.ca

About the study: Hypertensive disorders of pregnancy such as preeclampsia increase the risk of life-ending and life-altering complications for both the mother and her unborn baby. Oxygen levels in pregnant women are measured using a non-invasive and safe machine called the pulse oximeter to measure hypertension. The oxygen level is measured by placing a probe on a woman’s finger for one minute, and the information collected through this method is used for patient monitoring and diagnosis of pregnancy-related complications.

This research study is being done because, at present, there are no guidelines outlining the best finger to use for measuring the oxygen saturation in the blood in pregnant women. It might be that different fingers of the hand provide different quality of information, and it is important to identify which finger provides the highest quality of information so that clinicians can make more accurate diagnoses. Signal patterns will also be looked at to see if it is predictive of pregnancy outcomes.

Why is this research important? Collecting high-quality signals from the most appropriate finger will enhance current care models by helping clinicians make a more accurate diagnosis, improve early prediction of complications, and enable timely patient management in health care settings and around the world where this technology is used.

Study status: Recruiting, aim to recruit 200 women.

Who can participate? For this study, we will recruit women who have no hypertension and those who have hypertension developed during pregnancy. These women will be compared in the data analysis, and will also be looked at according to how many weeks gestation they are. You may be able to participate in this study if:
• You are pregnant at 20–40 weeks gestation
• You are 20 years of age or older
• You have a singleton pregnancy
• You are delivering at BC Women’s Hospital

Co-Investigators: Dr. Rabab Ward, Dr. Mohamed Elgendi, Dr. Judy Needham, Dr. Jayson Potts

Funded by: BC Children’s Hospital Research Institute
Partners: University of British Columbia, BC Women’s Hospital + Health Centre

Consent Form: of-consent-form-final__oct-31-2016-v2

“The Impact of Prenatal Screening for Fetal Aneuploidy on Maternal-Infant Bonding” (Pre-MIB) Study

The Impact of Prenatal Screening for Fetal Aneuploidy on Maternal-Infant Bonding (Pre-MIB) Study

Principal Investigator: Cartiona Hippman

Primary Contact: Nicole Prestley, Research Manager, 604-875-2424 ext 4956, Nicole.Prestley@cw.bc.ca

About the study: The purpose of this study is to assess how the option to have prenatal genetic screening for chromosome abnormalities can impact maternal-infant bonding during pregnancy. Chromosome abnormalities take place when an abnormal number of chromosomes are within a cell, which is known to be the cause of certain birth defects. Maternal-infant bonding (MIB) is the term used to describe the affectionate relationship that develops between a mother and her fetus/infant. The study involves participants completing a questionnaire and interview, with a total time commitment of 1 hour and 30 minutes.

Why is this research important? A strong MIB has been known to promote healthy lifestyle choices during pregnancy and positive longer-term consequences for later maternal-child interactions. MIB can be threatened by prenatal stress, and prenatal stress can be experienced during the prenatal genetic screening process.  It is hoped that the results from this study can improve maternal-infant bonding and women’s experiences of prenatal genetic screening.

Study status: Recruiting

Who can participate: Women over the age of 19, fluent in English, between 26-34 gestation who have chosen to have prenatal genetic screening.

Study results/publication: 

Preliminary results have been presented as an abstract at the 2015 conferences of the National Society of Genetic Counselors and Canadian Association of Genetic Counsellors. The abstract has been published in the Journal of Genetic Counseling: Hippman, C., Austin, J.C. Does a negative prenatal genetic screen result impact maternal-fetal bonding?  Journal of Genetic Counseling. 2015. 24(6). p1086.

Co-Investigator: Jehannine Austin

Funded by: National Society of Genetic Counselors, Prenatal Special Interest Group Grant Award

Consent Form: Pre-MIB Participant Consent Form