A food supplement used by athletes and body builders to boost muscle power might help to prevent brain damage and death of newborn babies from oxygen starvation, researchers say.

Problems with the placenta and umbilical cord before or during birth can reduce the fetal oxygen supply. One in 300 babies in developed countries suffers birth injuries as a result, and one in 20 babies in the UK are born by emergency caesarean section because doctors worry they may not be getting enough oxygen.

Now Zoe Ireland and David Walker at Monash University in Melbourne, Australia, think they may have found a simple way to reduce the risks.

They fed pregnant spiny mice a diet containing 5% of the organic acid creatine, which can protect cells by providing energy when oxygen levels are low.

When the researchers starved the mice of oxygen just before birth, 95% of pups whose mothers had been fed creatine survived, compared to only 63% of pups whose mothers did not receive the supplement.

"The pups of supplemented mice also grew better, and this may be because their suckling reflex was less affected by brain damage," says Ireland.

Nerve protection

Creatine is produced by the body and obtained from meat in the diet. To improve muscle performance, bodybuilders and athletes frequently use creatine supplements, which according to current medical opinion are safe to use - if used correctly.

Recent research on humans suggests that creatine supplements can also protect nerve cells from damage in patients with Huntingdon's disease or after traumatic brain injury, and that they may improve cognitive performance in vegetarians, who have less creatine in their diet.

The current study is the first to look at the effects of maternal creatine supplementation on the health of the fetus. Unlike house mice, which are born very immature, spiny mice are more comparable to human babies at birth, with open eyes and more advanced brain development. This makes them a good model to study questions about health during birth, says Walker.

'Potentially safe'

Theo Wallimann, a cell biologist at the Swiss Federal Institute of Technology (ETH) in Zürich, agrees that that the results may well hold true for humans.

"I am a strong advocate for creatine supplementation during pregnancy. However, the creatine dose used in these experiments was very high, and although preliminary trials suggest that even premature babies can tolerate high doses well, we obviously need more research", he says.

"We still need to prove that creatine can directly prevent brain damage", says Patrick O'Brien, of the Royal College of Obstetricians and Gynaecologists in London.

O'Brien believes that creatine supplementation could become a potentially safe and easy protective intervention, much like folic acid supplementation, which is now recommended to prevent neural tube such as spina bifida.

"Because such defects are thankfully rare, it also takes very large studies to show a protective effect in humans, so we still have a long way to go," he says.

Journal Reference: American Journal of Obstetrics and Gynecology (DOI: 10.1016/j.ajog.2007.10.790)