Like every parent whose premature child has severe Cerebral Palsy, I have spent hours agonizing over the possible causes of my child’s brain injury.
Initially we thought her injury was due to the traumatic birth but, truth be told, I found that really hard to believe.
During my years as a hospital doctor, I spent a lot of time in labour wards delivering babies and doing emergency Caesarian sections. I had seen enough dramatic and traumatic deliveries to know that babies are extremely robust. It takes a HUGE event to cause a brain injury at birth. Compared to these deliveries, Emma’s birth was a walk in the park. Yes, there were delays. Yes, I had the incorrect anaesthetic that day. Sure, there were other issues that could’ve contributed. But in my heart, I have always known there was more to the story than that.
So, true to form, I researched and read a lot about this. If I could understand the cause, it might help me to find a cure or an approach to healing.
And I was not the only one thinking like this. More and more researchers are looking at issues that can predispose a neonate to pre-term birth and developmental issues. There is a plethora of research that argues that in many cases, the actual traumatic event that leads to brain injury is likely to happen during the second trimester of pregnancy and not at the birth.
Intra-uterine infections and indirect injuries due to raised inflammatory cytokines in the mother (silent inflammation) are now being investigated as these factors seem to load the dice for a traumatic pre-term birth and all the risks that come with it.
This week I found a new piece of the puzzle that made me sit bolt upright (and cry a little). A group of studies in maternal care is now being taken seriously in various academic centres. The topic they all focus on is Vitamin D in pregnancy. As you know, I am a firm believer in optimising Vitamin D in all my patients. There is still much debate about this in the mainstream (and I’m not going to get into that here) however, a slow shift is finally starting to happen and allopaths are taking the issue of Vitamin D levels seriously.
So why all this fuss about Vitamin D? Briefly, there are only two hormones in the body that have binding receptors on every cell in the body. The one is the thyroid hormone, the other is our friend Vitamin D. Yes, Vitamin D is called a vitamin but its action is thought to be more like a hormone. Healthy amounts of Vitamin D are vital to the body. Vitamin D deficiency is connected to many inflammatory conditions, auto-immune conditions, cancer, pain, depression and bone density abnormalities. Vitamin D also helps the body fight infections. Recent evidence suggest that Vitamin D deficiency is rife. Up to 80% of pregnant mothers in the US are Vitamin D deficient.
The body can synthesise Vitamin D through noon-day sun exposure (15-20 mins) and through supplementation. Since so many people are staying out of the sun or live in low-light areas such as Europe, and as there is an increased demand for Vitamin D during pregnancy, the deficiency problems have been increasing. (Upon my return to South Africa, a sunny country, I was also surprised to find low Vitamin D in almost very other patient in my practice.) This is likely due to environmental factors such as persticides and other chemicals we are exposed to that block the synthesis and absorption pathways.
Back to the maternal studies I mentioned. The study leaders looked at older evidence that seemed to suggest that pre-term birth and intra-uterine infections were strongly correlated with Vitamin D deficiency. So, they devised a community project study where they invited pregnant women to enroll for a Vitamin D study. The Vitamin D levels of the women were checked at various intervals during pregnancy and the study sponsor supplied the participants with the Vitamin D supplementation. The pregnancy outcomes were tracked and compared to the pregnancy outcomes of the same geographic area prior to the Vitamin D study. The results of this project are now in – and they’re amazing.
Not only did pre-term birth numbers drop significantly when Vitamin D levels were optimised, but other complications such as intra-uterine infections, autism and pre-eclampsia were significantly decreased. Just to make the link to CP clear – Cerebral Palsy occurs in 60% of all premature births and is associated with intra-uterine infections of pregnancy. If you can prevent infections and premature birth, you can very likely help prevent Cerebral Palsy.
This is a huge finding and I hope it will herald further study and a roll-out of Vitamin D supplementation for pregnant moms. You can read more about this study and its findings here.
Here are the suggestions that came from this study:
• Optimise Vit D levels in both partners before conception.
• Check Vit D levels three times throughout the pregnancy.
• Aim for Vit D levels above 40ng/dl.
• Take Vit D3 supplementation (in consultation with your doctor). Amounts up to 4000IU is safe.
I would add that you make sure that your dietary intake of calcium, magnesium, and Vit K2 are also maintained at adequate levels since these nutrients are important for Vit D to do its vital job well.
I believe that this new finding might be an answer for the rampant pre-eclampsia incidents we see in South Africa. I look forward to seeing more exciting research in this space.
My Emma 