Embryo gene editing in IVF can have potential major impacts on humanity

A global conference on human fertility has been warned of huge societal and ethical challenges regulating advances in gene editing in assisted reproduction.

Speaking at the 10th Congress of the Asian Pacific Initiative of Reproduction (ASPIRE), Dr Catherine Racowsky said embryo gene editing was a growing likelihood among latest advances in IVF with potential major impacts on humanity.

“The international community is working hard to develop regulatory guidelines regarding alterations in human genetics, but big questions remain about how and where they will be applied,” she said.

Dr Racowsky, University Consultant of Hospital Foch in France, Professor Emerita of Obstetrics and Gynaecology at Harvard Medical School in the United States and Immediate Past President of the American Society for Reproductive Medicine, was a keynote speaker at the ASPIRE Congress, which is being presented in virtual format – https://aspire2021.cme-congresses.com – to fertility specialists in over 100 countries.

She said the first reported birth from a genetically modified embryo was reported in China in 2018 creating a global uproar for violating the international position on human gene editing.

Dr Racowsky said pre-implantation genetic testing (PGT) for embryo selection in IVF is already an accepted test to identify embryos at risk for genetic disorders being passed on to offspring.

New frontiers in germ line gene editing and mitochondrial replacement therapy (MRT) can also be applied to reduce or prevent genetic diseases being passed on to offspring. However, genetic testing also paves the way for embryo selection for desirable traits in offspring including height, eye color, athletic ability and IQ.

Mitochondria are tiny powerhouses within cells. Inherited from the mother via the egg, they turn consumed sugars, fats and proteins into chemical energy to support life, and they enhance the ability of cells to resist infection or injury.

Mitochondria carry their own DNA, but when there are genetic defects, or some form of damage occurs, transmission of serious conditions to an offspring may result.

MRT involves replacing or reducing the effect of mutated mitochondria by transferring the chromosomes from an affected egg into an egg with healthy mitochondria from a donor to allow for a healthy pregnancy and baby.

Dr Racowsky said there was a need for continuing wide ranging debate on ethical, societal and religious issues related to these technologies to avoid the possibility of changes in the genetic make-up of Homo sapiens.

“Alterations in the human germ line are likely to be introduced, but there are potential major impacts on humanity,” she warned.

“Huge scientific, clinical, financial and societal hurdles have been overcome in the 43 years since the world’s first IVF baby was born.

“But the emergence of new technologies including mitochondrial replacement therapy and embryo gene editing present important new challenges and concerns.”

Dr Racowsky said artificial intelligence and machine learning technologies were gaining traction in assisted reproduction, for example in selection of the best embryos for transfer in IVF.

We are in the early days in this field and we need to be careful that these new technologies are adequately validated”

Dr Racowsky, University Consultant of Hospital Foch in France

ASPIRE, the Asia Pacific Initiative on Reproduction, is a unique task force of clinicians and scientists involved in the management of fertility and assisted reproductive technology (ART) throughout the region, which contains about 60 per cent of the world’s population.

The ASPIRE Congress continues in virtual format until Sunday 9 May.

Source:

ASPIRE 2021 Virtual Congress

Posted in: Genomics | Life Sciences News

Tags: Artificial Intelligence, Baby, DNA, Embryo, Eye, Fertility, Gene, Genetic, Genetics, Gynaecology, Hospital, IVF, Machine Learning, Medical School, Medicine, Mitochondria, Obstetrics, Pregnancy, Reproduction, Traction

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Lala Kent Wants Another Baby With Randall Emmett: 'Clock Is Ticking'

Tick, tock! Lala Kent doesn’t want to waste any time welcoming her and Randall Emmett’s second child together.

Mini Mermaid! See Lala Kent and Randall Emmett’s Daughter Ocean’s Photos

“I definitely want to have another baby,” the Vanderpump Rules star, 30, recently told Us Weekly exclusively while promoting her memoir, Give Them Lala, ahead of its Tuesday, May 4, release. “It doesn’t have to be right away because I am just so in love, and I want to enjoy [my daughter, Ocean], for as long as possible. It’s like, ‘Clock is ticking, you better have another baby’ … but Randall says, ‘You’re so young.’ And I’m like, ‘You’re not.’”

The Utah native explained that she doesn’t want her fiancé, 50, “to be 90 years old walking into [their] son or daughter’s high school graduation.”

Celebrities Who Welcomed Babies Back-to-Back

Emmett, 50, previously welcomed daughters London and Rylee with his ex-wife, Ambyr Childers. Before his and Kent’s 1-month-old arrived in March, the Give Them Lala Beauty creator shared their future family plans.

“We’re just gonna make more babies,” the then-pregnant star told TooFab in January. “One more after this. Yeah, I think we’ll be good after that.”

The couple’s love has grown “so much deeper” since Ocean’s birth, Kent told Us. “I look at him like, ‘You’re the father of my baby. This is so crazy.’ … We share this little human, and the ultimate goal is to keep Randall and I good so that we can raise a healthy, happy child. The stakes are really high now.”

Lately, the new mom has found herself “cry[ing] all the time” due to postpartum hormones. She joked with Us that this is probably a welcome change for her fiancé since she was previously “a raging bitch.” Kent said, “Look at me the wrong way, and I’m, like, sobbing my eyes out.”

‘Vanderpump Rules’ Baby Fever! Bravo Stars’ Best Quotes About Having Kids

Living with Emmett’s eldest two children didn’t prepare the reality star to have a baby of her own, she went on to say. “Nothing compares,” Kent explained. “Now I understand. … I just think with being a stepmom, there are boundaries. There’s only so much that I can do as a stepparent to two little girls, so it’s very different. They are two very different things for me.”

While London “couldn’t care less” about Ocean, Rylee is “completely obsessed” with the infant. “It’s really sweet to watch her,” Kent told Us. “Every single holiday, she asks for any stuff. And now she has a real-life baby. Like, she’s beyond over the moon.”

Kent’s memoir, Give Them Lala, hits shelves on Tuesday, May 4.

With reporting by Christina Garibaldi

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See Drake and Sophie Brussaux's Son Adonis' Baby Album

Curly-haired cutie! Drake and Sophie Brussaux’s son, Adonis, arrived in October 2017 and made his social media debut more than two years later.

The rapper posted pictures of himself and the toddler in March 2020 amid the coronavirus pandemic, writing, “I love and miss my beautiful family and friends and I can’t wait for the joyful day when we are all able to reunite.”

Pusha T first revealed in May 2018 that Drake was a dad, sharing the news in “The Story of Adidon,” rapping, “You are hiding a child / Let that boy come home / Deadbeat motherf–ka, playin’ border control.”

The “God’s Plan” rapper confirmed the news the following month. “Yesterday morning was crazy / I had to come to terms with the fact that it’s not a maybe / That s–t is in stone, sealed and signed / She not my lover like Billie Jean, but the kid is mine,” the Degrassi alum rapped in “March 14,” released in June 2018. “[My mom] Sandi used to tell me all it takes is one time, and all it took was one time / S–t, we only met two times, two times.”

The Canadian star went on to rap directly to his baby boy, saying, “Fairytales are saved for the bedtime stories I tell you now / I don’t want you to worry about whose house you live at / Or who loves you more or who’s not there / Who did what to who ‘fore you got here.”

In December 2019, the Grammy winner opened up about why he waited to address the news about Brussaux’s birth. “To be honest with you, I did a DNA test for my son and it came back to us and it said the DNA test got ruined in transit and they couldn’t be 100 percent sure that that was my son or not,” he said during a “Rap Radar” podcast episode. “I was in a really weird pending situation where I didn’t want to go tell the world that that was my son and it wasn’t.”

Drake now has “no desire” to mend his and Pusha T’s relationship. “He told the world that the biggest artist at the time has a kid that he hasn’t told you about,” the American Music Award winner explained at the time. “I knew, for me, it was over at that point. It wasn’t even about battle rap.”

Keep scrolling to see photos of Drake’s son, Adonis, from family portraits to toy time.

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Katharine McPhee Shares 1st Pic With Baby Boy: 'I Love Being a Mommy'

That new mom glow. Katharine McPhee shared her first social media photo with her newborn son as she took her baby boy for a walk on Saturday, March 6.

Look Back at Katharine McPhee’s Baby Bump Pics

“Just in case you were wondering… I love being a mommy!” the singer, 36, captioned an Instagram Stories pic along with two crying emojis. The photo showed her wearing a black skirt and white long-sleeve T-shirt as she toted her boy in a baby carrier on her chest.

Us Weekly confirmed on February 24 that the former American Idol contestant and her Grammy-winning husband, David Foster, had welcomed their first child.

“Kat McPhee and David Foster are the proud parents of a baby boy,” her rep confirmed to Us, with a source telling Us that “everything went well. Mom and baby are healthy.”

Katharine McPhee and David Foster: A Timeline of Their Relationship

Us confirmed in October that McPhee was pregnant with the music producer’s sixth child. The Canada native, 71, shares daughter Amy, 47, with first wife B.J. Cook, and Sara, 40, Erin, 38, and Jordan, 34, with second wife Rebecca Dyer. His eldest child, Allison, 50, was given up for adoption but they later reconnected when she was an adult.

The couple’s baby news came a month after a source exclusively told Us that the couple were “definitely trying” to have a baby.

McPhee, who previously battled an eating disorder, revealed in an interview earlier this month that she’d worried about a relapse while pregnant.

Celebs Who Debuted Their Postpartum Bodies Days After Giving Birth

The Smash alum admitted on “Dr. Berlin’s Informed Pregnancy Podcast” that “body-issue stuff” was her “biggest challenge.”

“It just suddenly came up in a way that hadn’t been present in a long time,” she said in the interview that aired on Monday, March 1. “Feeling like there was a relapse after getting pregnant was shocking and upsetting and concerning for me because I was suddenly so obsessed with food, starting from this first trimester, and I had such a distortion of the way that I looked.”

McPhee, who gained about 40 pounds during her pregnancy, reached out to a psychiatrist for help and said that she is now “OK” with her body being “a little thicker.”

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Nikki Bella Wants Another Baby But Also a WWE Return: It’s a ‘Battle’

A tough choice ahead. Nikki Bella admitted to struggling with her desire to have a second child with fiancé Artem Chigvintsev — a decision she is contemplating along with her interest in returning to her WWE roots.

Everything We Know Pregnant Nikki Bella Has Said About Starting a Family

“I have such a battle in my head, because I would want to wait and then I’m like, ‘OK, so I’m closer to 40. How’s that going to be?’ And then I’m like, ‘No, no, no. I’m just going to have [my son] Matteo,’” Bella, 37, told Us Weekly exclusively on Thursday, March 4, while promoting her new Tearless haircare line for babies. “But it’s like, now that I have Matteo, I want to give him a sibling because when we see [my sister Brie Bella’s son] Buddy, and Buddy and [his sister] Birdie, I’m like, ‘Oh, no matter what, he’ll always be a sibling.’”

She continued, “It just makes me feel bad that when he goes to bed at night though, he’ll always be by himself. So, Artem — he wants one. If I could have a girl up here … he’d be in heaven.”

Though she is “actually thinking about having another baby,” she is also seriously considering making her way back to WWE.

Working Mom! See Nikki Bella’s Sweetest Pics With Son Matteo

“The thing is, I want to get back in the wrestling ring,” she revealed. “There’s so many things I want to do, and I feel bad. … I just don’t think I have time.”

The Incomparable author welcomed her son, Matteo, with Chigvintsev, 38, in July 2020. The pair’s newborn arrived just one day before Brie, 37, gave birth to her second child, Buddy, with husband Daniel Bryan.

As a silver lining to deciding on baby No. 2, going through pregnancy a second time wouldn’t be a foreign concept to Nikki.

“I feel like I’d be prepped differently and emotionally, I would be different,” she explained. “I think I was so afraid of Mateo or anyone touching him, or this or that. I would be different right from the beginning, for sure.”

See Nikki and Brie Bella’;s Sons Matteo and Buddy’s Sweetest Pics Together

Last year, the former Dancing With the Stars contestant revealed that she and her soon-to-be-husband have disagreed about the possibility of further expanding their brood. “I honestly want to be one and done,” she told Us in November 2020. “Artem really wants a little girl, but I just don’t know if I could do it again.”

Nikki, meanwhile, last mentioned the possibility of her returning to wrestling on The Ellen DeGeneres Show in January. The Total Bellas star noted that she’s “definitely” interested and expressed her excitement over an announcement WWE made about upcoming WrestleMania host cities.

“When I heard about Dallas 2022, Hollywood 2023, I got chills,” she recalled. “And I said, ‘Brie, we have never gone after the tag titles.’ They were made for us. There’s another run in the Bella twins. At some point, we’re coming back.”

In the meantime, Nikki and Brie are focusing on the launch of Tearless — a haircare line that they created just for babies. The new product line will serve as an expansion to the twins’ Nicole + Brizee company.

“Being a mom, every day you’re surrounded by baby products [and] using them. So, you’re constantly thinking about them,” Brie explained to Us. “Nikki and I were like, ‘This is our life now. So, why don’t we come up with our own baby line?’ That’s why we wanted to create Tearless.”

With reporting by Christina Garibaldi

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Celebs Who Hid Baby Bumps Amid Quarantine: Halsey and More

Under wraps! Pregnant celebrities, from Nicki Minaj to Lily Rabe, have hidden their baby bumps in quarantine amid the coronavirus pandemic.

The rapper hinted that she was pregnant with her and husband Kenneth Petty’s first child in May 2020 when she tweeted, “Lmao. No throwing up. But nausea and peeing non stop. Omg what do u think this means guys???? Lmaooooooooooo.”

The Grammy nominee added that she would share a photo of her budding belly “in a couple months,” explaining, “The world ain’t ready yet.”

True to her word, the “Good Form” rapper debuted her baby bump two months later. “#Preggers,” Minaj wrote via Instagram in July. “Love. Marriage. Baby carriage. Overflowing with excitement & gratitude. Thank you all for the well wishes.”

In the maternity shoot pictures, the Queen Radio host cradled her bare stomach. Later that same month, she showed her pregnancy progress while dancing to “Move Ya Hips” in an Instagram video.

Prior to her reveal, Minaj was vocal about her plans to become a mother. “[My biggest fear] is that I’ll become so consumed with work that I’ll forget to live my personal life to the fullest,” she told Complex in 2014. “If I’m done with my fifth album and I don’t have a child by then, no matter how much money I have, I would be disappointed, as a woman, because I feel like I was put here to be a mother. … I definitely will be married before I have my baby. I want to make sure I do it in that order. I’ve always felt like that since I was young; my mother always put that in my head.”

As for Rabe, the American Horror Story alum secretly welcomed her second child with boyfriend Hamish Linklater in June 2020 after keeping her pregnancy under wraps. The actress showed her baby bump in a throwback photo in August, writing via Instagram: “Looking back at a day in May. #wearamask.”

The New York native and Linklater have yet to share their little one’s name, in addition to their eldest daughter’s moniker. As for the Newsroom alum’s daughter with his ex-wife, Jessica Goldberg, the teenager’s name is Lucinda.

Keep scrolling to see how more celebrity parents kept their pregnancy news hidden during the COVID-19 spread, from How to Get Away With Murder’s Karla Souza to Ed Sheeran’s wife, Cherry Seaborn.

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Pregnant Brittany Cartwright Has ’10 Weeks to Go’: Baby Bump Pics

Prepping for parenthood! Brittany Cartwright has been giving fans glimpses of her pregnancy journey since her and husband Jax Taylor’s September 2020 announcement.

“Mom & Dad,” the Kentucky native captioned an Instagram slideshow at the time, showing off her baby bump as well as ultrasound photos. “The love of our lives is coming soon.”

The former Sur bartender shared the same shots on his account, writing, “Sooooo I am gonna be Dad.”

Prior to the couple’s reveal, the Michigan native hinted that he and his wife will welcome a baby girl.

“We’re very similar kind of guys and I just don’t think it’s in the cards for us to have boys,” Taylor told Randall Emmett during his and pregnant Lala Kent’s sex reveal. “I think it’s gonna be a girl.”

Sure enough, a pink parachute proved the reality star right. When Emmett, who shares two daughters with ex-wife Ambyr Childers, joked that he had “a house full of girls,” Taylor said that it was “a curse and also a blessing.”

The dad-to-be previously spoke to Men’s Health about his plans to be “the best” father possible. “I really want to be at every PTA meeting, every soccer practice, every ballerina class,” Taylor said in December 2018. “My dad was there.”

He went on to say that it was “time to start the next stage” of his life, explaining, “I’ve done everything I’ve wanted to do, partied my brains out, traveled the world.”

While the Vanderpump Rules stars were engaged at the time, the couple tied the knot in June 2019 in Kentucky. Ten months later, Taylor shared their plans to conceive their first child during a E! News’ Just the Sip appearance.

“We’re hoping to get a quarantine baby out of this,” he said in April 2020. “We’re ready to go.”

Keep scrolling to see Cartwright’s baby bump photos over the course of her pregnancy, from mirror selfies to maternity fashion.

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What Causes Coloboma?

Ocular coloboma is an abnormality of the eye resulting from its defective development. One or both eyes may be affected  by holes or gaps in the cornea, iris, ciliary body, lens, choroidal layer, lens, retina or optic disc. In many patients, a coloboma is accompanied by microphthalmia and anophthalmia, or other defects in various parts of the body.

Colobomas are present in 0.5–7.5 per 10,000 births, and can be caused by a genetic mutation or by toxic environmental factors.

Coloboma is an eye abnormality that occurs before birth. Colobomas are missing pieces of tissue in structures that form the eye.

What causes a coloboma?

As the baby develops in the womb, a specialized layer of ectoderm (the neuroectoderm), which gives rise to neural cells, comes to the surface to form the optic vesicle. This then invaginates, or curves inwards, to form two parts: the optic fissure in front and the optic cup towards the back. The optic fissure then closes as the two lips grow towards each other. Their fusion leaves only a small gap called the optic disc, through which the hyaloid artery enters the eye.

This fusion process occurs from the fifth to the seventh week of development. Any disruption can result in coloboma formation. The optic fissure is formed at the lower part of the eyeball, which means most colobomas are found there. The segment that remains unfused determines the part of the eye that is affected.

Some colobomas go unnoticed because they are very small and isolated. Others are larger but still isolated. More severe conditions result when a coloboma is associated with other abnormalities of the eye like microphthalmos. The most severe cases are when a coloboma is associated with anomalies of the brain and other systems outside the brain.

The classification of colobomas reflects the groups of coloboma genes involved and the period of development affected. Generally, the earlier in development a defect occurs, the more severe the congenital outcomes. Genes including SHH and SIX3 are involved in defects occurring before the 20th day of fetal development and result in severe anomalies of the eye, brain, and other organ systems. This is also traceable to the fact that SHH is a gene expressed in almost all tissues.

After this period, genes like TCOF1 may cause less severe defects of the brain and organs, whereas PAX6, MAF1, CHX10, or RBP4 can cause isolated colobomas.  MAF1 and similar genes are expressed only in the eye; hence, their expression results in a milder phenotype.

Another factor that comes into play is the presence of genetic redundancy, which means that some gene anomalies can be compensated for by other genes expressed in certain tissues like the brain, but not in the eye, for instance, where the compensatory genes are not expressed.

Genetic causes

Most syndromes associated with coloboma are the result of Mendelian inheritance or chromosomal anomalies. As of now, almost 40 genetic regions linked to coloboma formation have been traced to their chromosomal origins, and many of the genes have been identified as well.

Some known coloboma-associated genes include SHH, CHX10 and MAF. Three coloboma syndromes share the same genetic locus at 22q11, making this a likely location for one or more genes that are crucial to normal development of the eyes.
Autosomal dominant and autosomal recessive inheritance are found equally in 27 coloboma phenotypes which are not yet mapped, whereas three are supposed to be X-linked. For some, the mode of inheritance is not yet clear. Thus colobomas are not caused by any one gene, but are rather a part of a more widespread aberration in development.

Environmental causes

Present research shows at least 39 genes are involved in coloboma syndromes, or isolated coloboma. All these are crucial to early intrauterine development, particularly of the central nervous system. However, these mutations account for only about half of all colobomas, which means many more mutations that could cause this condition remain unknown.

Most sporadic cases of coloboma are unilateral and often due to environmental factors, leading to malformations in multiple systems of the body. One classic example is the CHARGE syndrome, wherein colobomas of the iris or uvea is present in almost 86% of patients. The mechanism by which this occurs is not always clear, but such conditions comprise a good percentage of patients with coloboma.

Some suggested environmental triggers (operating during pregnancy) include:

  • Drugs used in pregnancy, such as thalidomide (4%) and alcohol
  • Vitamin A and vitamin E deficiency
  • Infections with cytomegalovirus (CMV) and toxoplasmosis
  • Ionizing radiation exposure
  • Hyperthermia

Syndromes associated with coloboma

There are several conditions of which a coloboma forms a part, such as:

  • Treacher-Collins syndrome
  • Cat-eye syndrome where the coloboma is a vertical one in the iris, caused by an abnormality of chromosome 22q11
  • Patau syndrome caused by an extra copy of chromosome 13 (trisomy 13)
  • Coloboma with cryptophthalmos where the eyelids are absent
  • CHARGE syndrome which stands for a constellation of Coloboma, Heart defects, Atresia of the nasal choanae, Growth retardation, Genital anomalies and Ear abnormalities, sometimes with microphthalmia
  • Manitoba oculotrichoanal syndrome with multiple physical anomalies of the eyes, hair and anal opening
  • Fraser syndrome with webbing and number abnormalities of the fingers or toes, or both, with renal and genital abnormalities and sometimes cryptophthalmos
  • Goldenhar syndrome with faulty development of the ear, nose, soft palate and jaw
  • Amniotic band syndrome
  • Aicardi syndrome, Noonan syndrome, renal coloboma syndrome and Solomon syndrome

Sources

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257322/
  • https://www.ncbi.nlm.nih.gov/books/NBK532877/#_article-21509_s6_
  • https://ghr.nlm.nih.gov/condition/coloboma#genes
  • www.ncbi.nlm.nih.gov/pmc/articles/PMC1735648/pdf/v041p00881.pdf

Further Reading

  • All Coloboma Content
  • What is Coloboma?
  • What are the Symptoms Coloboma?
  • Treating and Managing Colobomas

Last Updated: Mar 20, 2019

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

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Dangers of Vitamin Deficiency During Pregnancy

Skip to:

  • What vitamins and nutrients are essential during pregnancy?
  • Vitamin B12
  • Vitamin C
  • Vitamin D
  • Folate
  • Iron
  • Calcium
  • What are the dangers of vitamin deficiency during pregnancy?
  • Vitamin B12 deficiency
  • Vitamin D deficiency
  • Vitamin C deficiency

During pregnancy, the body prepares for the fetus’ development and the breastfeeding process.  The body goes through many physical and hormonal changes. The mother needs to consume more foods rich in vitamins and nutrients to support the baby.

Proper weight gain and eating healthily reduces the risk of complications. Subsequently, the woman’s nutritional condition affects the infant later in life, particularly in his cognitive development, heart health, and the tendency to become overweight or obese.

The food pregnant mothers eat is the major source of nourishment of the body, so it’s vital to consume foods that are rich in vitamins and nutrients.

What vitamins and nutrients are essential during pregnancy?

Vitamin B12

Vitamin B12 or Cobalamin is an essential vitamin that plays a pivotal role in the production of red blood cells. It’s also important for neurological function and DNA synthesis. Vitamin B12, which is bound to protein in food, is released by the activity of gastric protease and hydrochloric acid in the stomach.

When combined with folic acid during pregnancy, vitamin B12 can help prevent spina bifida and other spinal or central nervous system birth defects. Mothers deficient in B12 are more likely to give birth to infants affected by spina bifida.

The major sources of vitamin B12 are beef, ham, pork, fish, dairy products, eggs, chicken, nutritional yeast products, and lamb.

Sources of Vitamin B12 (Cobalamin). Image Credit: Bitt24 / Shutterstock

Vitamin C

Vitamin C, also known as ascorbic acid, is a vitamin that occurs naturally in some foods. It can also be available as a dietary supplement. Vitamin C is an antioxidant that’s important for the skin, bones, and connective tissues. Aside from this, it helps the body absorb iron and boost the immune system.

Vitamin C during pregnancy may help reduce complications such as maternal anemia, intrauterine growth restriction, and pre-eclampsia. The most common sources of vitamin C include broccoli, greens, tomatoes, citrus fruits, and red or green peppers.

Foods High in vitamin C. Image Credit: bitt24 / Shutterstock

Vitamin D

Vitamin D helps the body absorb calcium, which is needed for strong bones. People can get vitamin D by exposing bare skin to sunlight. You can also get vitamin D through supplements and diet.

Vitamin D is very important for mothers and their developing babies. It plays an important role in bone metabolism by regulating the calcium and phosphate balance. It also helps reduce the risk of low birth weight, pre-eclampsia, and preterm birth.

Foods rich in vitamin D include fatty fish such as salmon, mackerel, and tuna, beef liver, egg yolks, and cheese.

Foods rich in vitamin D. Image Credit: bitt24 / Shutterstock

Folate

Folate is a B-vitamin that helps produce DNA and other genetic materials. Folate is important in red blood cell production and to reduce the risk of neural tube defects, such as spina bifida.

Foods rich in folate include legumes, asparagus, leafy green vegetables, beets, eggs, citrus fruits, broccoli, and brussels sprouts. Both dietary consumption and supplementation are recommended. To be effective in preventing neural tube defects during development, women wishing to become pregnant should initiate folate supplementation prior to conception.

Iron

Iron is an important mineral needed by the body for various functions. For instance, iron is a part of hemoglobin, a protein that carries oxygen from the lungs to the different cells of the body. Plus, it aids in the storage and use of oxygen in the muscles.

During pregnancy, the body’s blood volume rises to compensate for the increased demand for nutrients and oxygen. The demand for iron goes up to cope with the increased blood supply. The needed amount of iron should be doubled to about 27 mg per day. The most common sources of iron include green leafy vegetables, beans and lentils, tofu, cashews, fortified breakfast cereals, baked potatoes, and whole grains, to name a few.

Calcium

Calcium, a mineral important for life, helps build bones. It also enables the blood to clot, aids in muscle contraction, and helps the heart to beat. But, about 99 percent of all calcium stores in the body is in the bones and teeth.

During pregnancy, the body needs calcium from food or supplements. The recommended dosage is about 1,000 mg of calcium each day. Foods rich in calcium include cheese, milk, and yogurt.

What are the dangers of vitamin deficiency during pregnancy?

Vitamin deficiency during pregnancy may cause a wide array of maternal and fetal complications.

Vitamin B12 deficiency

Low levels of vitamin B12 during pregnancy may increase the likelihood of neural tube defects. In a study, the researchers found that mothers of children affected by neural tube defects had significantly lower vitamin B12 status.

Vitamin D deficiency

Vitamin D deficiency has been associated with an increased prevalence of pre-eclampsia, which is a common cause of mortality among pregnant women and their infants. According to a study, adverse health outcomes such as low birth weight, pre-eclampsia, neonatal hypocalcemia, bone fragility, heightened risk of developing of autoimmune diseases, and poor postnatal growth have been linked to low vitamin D levels during pregnancy.

Vitamin C deficiency

Vitamin C deficiency among pregnant women may lead to serious health effects on the fetus’ brain. In a study, the researchers said that even marginal vitamin C deficiency in the mother prevents the baby’s hippocampus, an important part of the brain responsible for memory, from developing by about 10 to 15 percent.

The best way to ensure that a woman’s body has appropriate vitamin levels to support a healthy pregnancy is to establish healthful eating habits prior to becoming pregnant. A prenatal care visit is highly recommended to address any potential nutritional deficits that should be addressed prior to trying to conceive. Folate supplementation is also recommended pre-conception and during pregnancy to prevent neural tube defects. The usefulness of vitamin supplements during pregnancy for vitamin B12 and vitamin C is less clear and is currently under study. Healthcare providers may recommend that pregnant women take calcium and iron supplements during pregnancy to ensure that the mother has appropriate levels to maintain her own bone and blood health.

Sources

  • American Pregnancy Association. (2019). https://americanpregnancy.org/pregnancy-health/vitamin-b-pregnancy/
  • National Institute of Child Health and Human Development. (2017). www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/prenatal-care
  • Pannia, E., Cho, C.E., Kubant, R., Sanchez-Hernandez, D., Huot, P.S.,  Anderson, H. (2016). Role of maternal vitamins in programming health and chronic disease. Nutrition Reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892288/
  • Rumbold, A, Nagata, O., Shahrook, S., and Crowther, C.A. (2015). Vitamin C supplementation in pregnancy. Cochrane Database of Systematic Reviews. https://www.ncbi.nlm.nih.gov/pubmed/26415762
  • Chidambaram, Balasubramaniam. (2012). Folate in pregnancy. Journal of Pediatric Neurosciences. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519088/
  • Molloy, A., Kirke, P.,Troendle, J., Burke, H., Sutton, M., Brody, L., Scott, J., and Mills, J. (2009). Maternal Vitamin B12 Status and Risk of Neural Tube Defects in a Population With High Neural Tube Defect Prevalence and No Folic Acid Fortification. Pediatrics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161975/
  • Finkelstein, J., Layden, A., Stover, P. (2015). Vitamin B-12 and Perinatal Health. Advances in Nutrition. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561829/
  • McCullough, M. (2007). Vitamin D Deficiency in Pregnancy: Bringing the Issues to Light. The Journal of Nutrition.  https://academic.oup.com/jn/article/137/2/305/4664522
  • Mulligan, M., Felton, S., Riek, A., and Bernal-Mizrachi, C. (2009). Implications of vitamin D deficiency in pregnancy and lactation. American Journal of Obstetrics and Gynecology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540805/
  • Nyborg, P., Vogt, L., Schjoldager, J., Jeannet, N., Hasselholt, S., Paidi, M., Christen, S., and Lykkesfeldt, J. (2012). Maternal Vitamin C Deficiency during Pregnancy Persistently Impairs Hippocampal Neurogenesis in Offspring of Guinea Pigs. Plos One. journals.plos.org/plosone/article?id=10.1371/journal.pone.0048488

Further Reading

  • All Pregnancy Content
  • Early Signs of Pregnancy
  • Is it Safe to Exercise During Pregnancy?
  • Pregnancy: 0-8 weeks
  • Pregnancy: 9 – 12 weeks
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Last Updated: Aug 13, 2019

Written by

Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She is currently completing her Master's Degree where she specialized in Maternal and Child Nursing and worked as a clinical instructor and educator in the School of Nursing at the University of Baguio.

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Baby born with heart defect faces more challenges after stroke

AHA news: baby born with heart defect faces more challenges after stroke

Kayla Scritchfield had a normal pregnancy and delivered her second daughter, Ava, thinking all was well. About six hours later, Ava looked purple. Medical personnel whisked away the newborn.

Kayla and her husband, Garrett, were told that Ava probably had a heart defect. She needed to be transported from Salina, Kansas, to Kansas City.

Garrett flew with the medical team and his intubated daughter, wondering if she would survive. After they arrived, doctors inserted a stent to open an artery in Ava’s heart, which had a defect known as transposition of the great arteries. The condition results from the two large arteries of the heart (aorta and pulmonary artery) being connected to the wrong heart chamber.

Open-heart surgery could correct the problem. But Ava’s heart wasn’t strong enough. She healed for 10 days.

The night before Ava’s surgery, Kayla and Garrett were headed out of the hospital for a bite to eat when they got a call to come back. No explanation was given.

Doctors and nurses filled Ava’s room. The nurse assigned to Ava for the night was crying in the hallway. The couple wasn’t allowed in the room. A doctor came out and explained they were trying to start Ava’s heart again because of an error.

“They were changing the IV line, which didn’t get fully locked to keep out all the air, so air slowly filled her IV line when they turned it back on. Air went to her heart and caused her heart to stop. And then as it moved up, it went to her brain and caused her to have a massive stroke,” Kayla said.

Doctors got Ava’s heart beating again, then sent her for tests to look for brain damage. Other evidence of the trauma already was evident. Ava was swollen and her face and hands were covered in deep red splotches because as the air embolism traveled through her body, it burst blood vessels.

“They warned us that there could be some major brain damage or that she could possibly be brain-dead based on the amount of air that had traveled to her brain, which was hard to hear,” Kayla said.

Thankfully, Ava’s brain showed activity, even though it also had some dead spots. She had 20 subclinical seizures, meaning they were experienced but were not visible. Staff took X-rays of Ava’s bowels and intestines to watch the embolism as it worked its way out of her system, checking to see that it didn’t perforate anything.

A day and a half later, Ava woke up and was alert, promptly getting hiccups at 5 p.m. – the same time of day she did when she was in the womb. It was a soothing, positive sign that things may be improving.

At 20 days old, doctors successfully performed her nine-hour heart surgery. Ava was soon ready to go home to Lindsborg, Kansas. By year’s end, she didn’t need any more seizure medication. She did have lingering effects from the stroke, specifically right-sided deficits that left her with braces on her legs and hand.

Now 3, Ava runs and plays and interacts with other kids as best she can. Twice a week, she goes to preschool, where she gets physical, occupational and speech therapy. She receives additional physical and speech therapy at an infant child development center nearby.

“If you didn’t know the background and her story, without watching her closely, you would never be able to tell that she went through all that,” Kayla said. “I always say she’s very resilient and determined.”

Garrett called her a fighter who makes the family smile.

“She’s one of the happiest kids you’ve ever seen,” he said. “She’s got a laugh that will light up a room real quick.”

Ava’s 7-year-old sister, Maleah, helps the family share Ava’s heart story by raising money as part of the American Heart Association’s Kids Heart Challenge that helps children learn how to have a healthy heart. Kayla and Ava also go to schools to discuss how some children are born with congenital heart defects.

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