Dickinson Hayley, Ellery Stacey, Ireland Zoe, LaRosa Domenic, Snow Rodney, Walker David W
The Ritchie Centre, MIMR-PHI Institute of Medical Research, Monash University, 27-31 Wright St,, Clayton, Melbourne 3168 Australia.
BMC Pregnancy Childbirth. 2014 Apr 27;14:150. doi: 10.1186/1471-2393-14-150.
While the use of creatine in human pregnancy is yet to be fully evaluated, its long-term use in healthy adults appears to be safe, and its well documented neuroprotective properties have recently been extended by demonstrations that creatine improves cognitive function in normal and elderly people, and motor skills in sleep-deprived subjects. Creatine has many actions likely to benefit the fetus and newborn, because pregnancy is a state of heightened metabolic activity, and the placenta is a key source of free radicals of oxygen and nitrogen. The multiple benefits of supplementary creatine arise from the fact that the creatine-phosphocreatine [PCr] system has physiologically important roles that include maintenance of intracellular ATP and acid-base balance, post-ischaemic recovery of protein synthesis, cerebral vasodilation, antioxidant actions, and stabilisation of lipid membranes. In the brain, creatine not only reduces lipid peroxidation and improves cerebral perfusion, its interaction with the benzodiazepine site of the GABAA receptor is likely to counteract the effects of glutamate excitotoxicity - actions that may protect the preterm and term fetal brain from the effects of birth hypoxia. In this review we discuss the development of creatine synthesis during fetal life, the transfer of creatine from mother to fetus, and propose that creatine supplementation during pregnancy may have benefits for the fetus and neonate whenever oxidative stress or feto-placental hypoxia arise, as in cases of fetal growth restriction, premature birth, or when parturition is delayed or complicated by oxygen deprivation of the newborn.
虽然肌酸在人类孕期的应用尚未得到充分评估，但在健康成年人中长期使用似乎是安全的，而且其有充分文献记载的神经保护特性最近得到了进一步拓展，有证据表明肌酸可改善正常人和老年人的认知功能，以及睡眠不足者的运动技能。肌酸有许多可能对胎儿和新生儿有益的作用，因为孕期是代谢活动增强的状态，而胎盘是氧自由基和氮自由基的关键来源。补充肌酸的多重益处源于肌酸-磷酸肌酸（PCr）系统具有重要的生理作用，包括维持细胞内ATP和酸碱平衡、缺血后蛋白质合成的恢复、脑血管舒张、抗氧化作用以及脂质膜的稳定。在大脑中，肌酸不仅能减少脂质过氧化并改善脑灌注，它与GABAA受体苯二氮䓬位点的相互作用可能会抵消谷氨酸兴奋性毒性的影响——这些作用可能保护早产和足月胎儿的大脑免受出生时缺氧的影响。在本综述中，我们讨论了胎儿期肌酸合成的发育、肌酸从母体向胎儿的转运，并提出在孕期补充肌酸可能对胎儿和新生儿有益，只要出现氧化应激或胎儿-胎盘缺氧的情况，如胎儿生长受限、早产，或分娩延迟或因新生儿缺氧而出现并发症时。
