Studies of melatonin in humans with IUGR and pre-eclampsia are now in their earliest phases. In animal studies, it has been shown that supplementation with melatonin decreases the risk of pre-eclampsia, preterm birth and intrauterine growth retardation (IUGR). Interestingly, the placenta produces melatonin and this source of melatonin is thought to be important to a normal, healthy pregnancy. Most of this research comes from animal studies, where it has been shown that melatonin can reduce oxidative stress, acting as an oxidant and scavenging free radicals. That said, there is some very interesting research going on with regard to melatonin and pregnancy. Thus, we typically advise women with sleep problems to use medications with a better characterized reproductive safety profile. As is the case with most supplements, we know very little about the impact these high levels of hormones may have on the developing fetus. Although melatonin is indeed “natural” and is normally produced by the body, the amount delivered by various over-the-counter preparations typically exceeds the quantities normally produced by the body. When it comes to pregnancy, natural does not necessarily mean safer. A typical dose of melatonin (1 to 3 mg) elevates blood melatonin levels up to 20 times normal levels. The dose used in most melatonin preparations is higher than what the body normally produces. Because it is not classified as a drug or hormone, its production is not monitored by the Food and Drug Administration. It is also sold over the counter as a dietary supplement and is a popular natural remedy for sleep problems. Melatonin is a hormone secreted by the pineal gland which is involved in regulating normal sleep-wake cycles. While these drugs are highly effective, many women with sleep problems inquire about the use of “natural” agents, such as melatonin, during pregnancy. In a previous post, we discussed the use of different types of medications to treat insomnia during pregnancy. For a significant number of women, the sleep disruption may be so severe as to require some type of intervention. Many women experience some degree of sleep disturbance during pregnancy.
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