Sarah Mount: Pregnancy, Hypercoagulability, and Erythritol
Sarah Mount, Postdoctoral Researcher at Maastricht University, shared on LinkedIn:
”Pregnancy, Hypercoagulability, and Erythritol — A Conversation We Should Be Having
Pregnancy is not a neutral physiological state when it comes to clotting.
It is a well-established hypercoagulable condition, designed to protect against haemorrhage — but one that increases the risk of thrombosis.
That baseline risk is compounded by:
- Gestational diabetes
- Hypertensive disorders of pregnancy (including pre-eclampsia)
- Chronic hypertension
- Obesity and metabolic dysfunction
- Inherited thrombophilia’s ex. Factor V Leiden (often undiagnosed, as universal screening is not routine).
Placental function depends on stable microvascular blood flow. When thrombotic risk rises, placental complications — including abruption and infarction — can escalate rapidly.
Now consider emerging data on erythritol (E968).
A 2023 study published in Nature Medicine reported that higher circulating erythritol levels were associated with increased risk of major adverse cardiovascular events (MI, stroke, death) over three years in high-risk populations.
Experimental components of the study demonstrated enhanced platelet activation and thrombosis formation in vitro and in animal models.
A subsequent human intervention study showed that ingestion of erythritol-sweetened beverages can produce plasma levels associated with these pro-thrombotic effects.
Moreover, there are more recent studies examining erythritol and blood-brain barrier integrity, as well as cardiovascular event risks.
Importantly:
These studies show association and mechanistic plausibility — not proven causation.
Erythritol remains ‘generally recognised as safe’ under current regulatory frameworks. Pregnancy-specific outcome data are lacking.
But here is the clinical question:
In a population already in a hypercoagulable state — sometimes with additional metabolic, hypertensive, or genetic risk factors — does it seem unreasonable to at least discuss minimising exposure to compounds with emerging pro-thrombotic signals?
This is not alarmism. It is risk stratification.
At minimum, this appears to be a reasonable topic for informed discussion between pregnant patients and their obstetric providers.
And then there is labelling…”
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