Pregnancy-Related Issues

Pregnancy-Related Issues: Overview

The following information is for women who are already pregnant as well as those likely to become pregnant soon.  It must be emphasized that you should think about preparing your body nutritionally for a healthy pregnancy before conception.

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Pregnancy is all about change.  It can be a challenging time both emotionally and physically.  But with the right approach, some enthusiasm, positive thinking, professional guidance and support from friends and family, it can be a time of learning, a renewed feeling of health and the beginning of a rewarding relationship with your new family.

Treatment and Prevention

Taking good care of both yourself and your partner before conception will help ensure that both of you and your baby stay healthy throughout the pregnancy and beyond.  One of the reasons for this is that the development of the sperm and the egg can be affected by various personal and environmental factors.  Before deciding to have a baby, you should try and ensure that you are healthy physically and emotionally including:

  • Being within the recommended healthy weight range for your height and build.  Losing or gaining that extra weight once you are pregnant is not a good idea.
  • Avoiding as much as possible any artificial additives in foods, and environmental chemicals/pollutants.
  • Quitting (or at least very much reducing) your smoking and alcohol consumption.
  • Managing lifestyle stress, for example by avoiding stressful situations, by exercising, relaxing and enjoying the outdoors.
  • Ensuring your diet is adequate in providing all the nutrients you require.

Smoking
An estimated 18-20% of pregnant women smoke throughout their pregnancies.  Smoking is associated with multiple complications in pregnancy.  Studies have confirmed that smoking increases the rate of low birth weight babies, premature babies, spontaneous abortions, stillbirths, neonatal death, abruptio placentae, placenta previa, bleeding during pregnancy, prolonged rupture of membranes, and impaired development of the infant.  This can be attributed to several factors such as the vasoconstriction of placenta blood flow by nicotine, elevated fetal carboxyhemoglobin and catecholamine levels, fetal tissue hypoxia, reduced delivery of nutrients to the fetus, and increased heart rate and blood pressure.

Maternal smoking accounts for 21% to 39% of all low birth weight babies (less than 2,500gm) in the US, which is very significant because birth weight is the single most important determinant of neonatal and infant morbidity and mortality.

Smoking women are at greater risk of spontaneous abortion of chromosomally normal conceptions.  Women smoking 10 or more cigarettes per day have a 46% greater chance of aborting, while women smoking more than 20 cigarettes per day have a 61% greater chance of aborting than do nonsmoking women.  The risk of congenital defect in the children of smoking women is 1.7 to 2.3 times greater than that of nonsmoking women.

Smoking is also a known risk factor for infant mortality.  Infant mortality per 1000 subjects adjusted for age, parity, education, and marital status were 15.1 for nonsmoking whites, 18.8 for whites smoking one pack of cigarettes per day, and 23.3 for whites smoking more than one pack per day.  The infant mortality rates per 1000 subjects for blacks were much higher; 26.0 for nonsmoking mothers, 32.4 for one pack per day, and 39.9 for more than one pack per day.  Children of smokers are more likely to die from sudden infant death syndrome (SIDS).

Nutrition
Healthy eating is essential for you and your baby to have the best chance of staying healthy and happy.  Remember that while you are pregnant you are the only source of the essential nutrients your baby needs to grow adequately and be healthy.  If your intake of these nutrients is insufficient, your baby's requirements will not be met or the nutrients will be removed from your own body structure to satisfy the baby's needs, both of these being unhealthy.  The important principles are to avoid the foods which can harm the baby, to select a variety of foods from each of the food groups (and vary this choice according to what you most want at the time because this is probably what your body needs), and to eat in moderation (eating for two does not mean eating twice as much!)

Medical journals are packed with studies advocating a nutrient-rich diet and sensible supplementation for expectant mothers.  German research bears this out with evidence that women who use multiple prenatal supplements can expect up to a 17% reduction in birth defects for their newborns [Hort A, Bran H.  Gesundheitswesen 1997;59(4): pp.248-51].  Which nutrients do you need and why? Some supplements are more vital to a comfortable pregnancy and a healthy baby than others.

  • Folic Acid Is Critical. Folic acid plays a critical role for the developing fetus by preventing neural tube defects such as spina bifida, a condition in which parts of the spinal cord are unprotected by vertebrae, and anencephaly, a fatal defect in which both the skull and most of the brain are missing.
  • Prevent Anemia with Iron. Adequate iron intake is important during pregnancy, a time when some women become anemic.  Studies show that women who have iron-deficiency anemia run the risk of delivering shorter, smaller babies.  [Preziosi P, et al.  Am J Clin Nutr 1997; 66: pp.1178-82]
  • Calcium & Vitamin D for Bones. Calcium is the final critical component of gestational nutrition.  It is primarily used for building a fetus' bones and teeth, although cells and blood also rely on calcium to function.  Vitamin D is essential for calcium absorption and bone formation in babies.
  • MagnesiumNausea, Cramps, Edema And More. Magnesium is essential for maintaining a healthy pregnancy.
  • Other Nutrients for Good Measure. Vitamin B6, a nutrient needed for amino acid metabolism, is also required for your growing baby.  Much of the way your baby develops essential proteins, such as DNA and insulin, depends on zinc.
  • Protein. Sufficient protein can be important in preventing preeclampsia.

Remember, a vitamin pill can't replace a healthy diet.  If you're pregnant, eat wholesome foods such as whole grains, fresh vegetables and fruits, beans, legumes, nuts, seeds, and lean meats.  Most importantly, work with your primary care practitioner to determine which dietary and supplement programs are best for you and your growing baby.

D (formerly Rh) blood typing and antibody screening is recommended for all pregnant women at their first prenatal visit.  Repeat antibody screening at 24-28 weeks gestation is recommended for unsensitized D-negative women.

Once the baby is born...
Keeping a child's environment too clean can increase the risk of developing allergies.  Reduced microbial stimulation during infancy and early childhood may result in slower postnatal maturation of the immune system and increase allergy risk.

Breast feeding for at least 4 months or, to a lesser degree, consumption of oily fish or Omega 3 fatty acids during pregnancy, improved maturation of babies' visual cortexes with resulting better vision at 3 1/2 years of age.

Screening for congenital hypothyroidism with thyroid function tests on dried-blood spot specimens is recommended for all newborns in the first week of life.

Complications

Pregnant women who undergo amniocentesis in pregnancy have a slightly increased risk of having an infant with clubfoot, but delaying the test slightly can significantly reduce this risk.

Signs, symptoms & indicators of Pregnancy-Related Issues:

Symptoms - Abdomen

Symptoms - Hair

Recent dry/recent oily hair

Hormonal changes during pregnancy can affect the hair in various ways, including making dry hair oilier (or drier), and oily hair drier (or oilier).  When excess androgen hormones are produced, the result can be oily hair and skin.

Symptoms - Skin - Conditions

Whitish nipple discharge

Some women have nipple discharge very early in pregnancy.

Symptoms - Skin - General

Red palms/fingertips

The palms of the hands can become pink or red during pregnancy due to increased blood flow.  This should disappear after delivery.

Symptoms - Sleep

Regular/frequent bizarre dreams

Many pregnant women experience vivid dreams, both pleasant and disturbing.  These appear to be caused by hormonal changes and are a way for an expectant mother to come to terms with the fears that accompany the birth of a child.

Conditions that suggest Pregnancy-Related Issues:

Infections

West Nile Virus

Pregnancy is a risk factor for developing a worse form of the disease.  It is possible for an infected mother to transmit the virus to her child via breast milk.

Lab Values

Laboratory Test Needed

Hormone Imbalance

Pregnancy can cause a significant hormonal imbalance.

Symptoms - Reproductive - General

Risk factors for Pregnancy-Related Issues:

Dental

Periodontal Disease - Gingivitis

Pregnant women with periodontal disease are statistically more likely to have a baby that is born prematurely, according to a study of more than 2,000 pregnant women.  This connection is not yet fully understood but may be due to underlying inflammation or infections.

Conversely, pregnancy and its related hormonal changes appear to worsen gum disease and tooth loss.  During pregnancy the body experiences hormonal changes that can affect many tissues, including the gums.  Gums can become sensitive and at times react strongly to the hormonal fluctuations, which may in turn increase the susceptibility to gum disease.

Nutrients

Manganese Requirement

There is a risk of fetal malformations, including increases in neural tube defects, without an adequate amount of manganese.

Symptoms - Environment

Being a smoker

Women who smoke during pregnancy are at risk of premature birth, pregnancy complications, low-birthweight infants, stillbirth and a higher overall rate of infant mortality.  For pregnant women and new mothers, smoking puts their baby at risk of sudden infant death syndrome (SIDS), poor lung development, asthma and respiratory infections.  Women who smoke during pregnancy also have an increased risk of having a baby with clubfoot.

Symptoms - Food - General

Long-term/short-term low-carb dieting

Acetone and other ketones (part of being in a state of ketosis brought on by following a low-carbohydrate diet) seems to cause brain damage in the fetus which may result in the baby being born mentally retarded.  [Maryland State Medical Journal 1974: p.70]

Despite the fact that ketones seemed to cause "significant neurological impairment" and an average loss of about 10 IQ points was well known and arousing "considerable concern" years before Atkins published his Diet Revolution [Clinics in Endocrinology and Metabolism 12(1983): p.413], Atkins nonetheless wrote "I recommend this diet to all my pregnant patients." [Atkins, RC.  Dr. Atkins Diet Revolution.  David McKay Company, Inc., 1972]

After enough pressure from the AMA, Atkins finally relented.  "There's one other point I'm really sorry about." Atkins finally admitted, "I now understand that ketosis during pregnancy could result in fetal damage.  My pregnant patients have never had this problem, but I realize I didn't study enough cases to validate my recommendation.  If anyone wants a retraction, I'll be glad to give one." [New York magazine March 1973.]

Symptoms - Food - Intake

Symptoms - Muscular

Being very skinny

Aside from increased risk of miscarriage, a Swedish study of 943,000 women found that very thin women are also at risk of severe nausea during pregnancy.  This study also found that women who are underweight before pregnancy are 43% more likely to develop hyperemesis gravidarum, which is non-stop vomiting.

Symptoms - Reproductive - General

Counter-indicators
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Pregnancy-Related Issues suggests the following may be present:

Hormones

Counter-indicators
Estrogens Low

Hormone levels fluctuate at different stages of pregnancy, making it difficult to isolate any underlying imbalances during this time.

Counter-indicators
Progesterone Low or Estrogen Dominance

Hormone levels fluctuate at different stages of pregnancy, making it difficult to isolate any underlying imbalances during this time.

Pregnancy-Related Issues can lead to:

Nutrients

Recommendations for Pregnancy-Related Issues:

Botanical

Not recommended
Ginger Root

Do not use more than 3-5gm of dried ginger per day during early pregnancy.

Not recommended
Orange Peel (Extract)

Use of orange peel extract is not recommended during pregnancy or while nursing.

Not recommended
Kava

Kava use is discouraged during pregnancy due to possible complications.

Not recommended
Parsley

Parsley contains essential oils; the most important one, apiole, is a kidney stimulant.  Because these essential oils can stimulate uterine contractions, pregnant women should avoid eating large quantities of it.

Not recommended
Saw Palmetto

Saw palmetto should not be taken by women who are pregnant, nursing or trying to conceive, because it affects sex hormone levels.

Not recommended
Not recommended
Vitex / Chasteberry

Vitex should not be used by pregnant women.

Chemical

Not recommended
Boric Acid

Boric acid should not be used when you are pregnant.

Not recommended
BHT (Butylated Hydroxytoluene)

BHT should not be used supplementally in pregnancy although there is no evidence that consuming foods where it has been added as a food preservative is harmful.

Diet

Caffeine/Coffee Avoidance

Human studies have found an increase in the rate of miscarriages, stillbirths, breech births and low birth weight when given in doses greater than 300mg (an amount equal to three cups of coffee) per day.  Pregnant women are also three times slower to metabolize caffeine than nonpregnant women.  Therefore, it is recommended that pregnant women consume less than this amount – in fact some doctors say that coffee should be completely avoided during pregnancy and breast feeding.

Fetuses and newborns cannot metabolize caffeine in their livers, so it remains in their bodies for up to four days, stimulating their nervous system the entire time, causing irritability and sleeping difficulty.  In addition, the use of large amounts of caffeine by a mother during pregnancy may cause problems with the heart rhythm of the fetus.

Studies in animals have linked high blood levels of caffeine to premature birth, delivery complications, low birth weight and birth defects when given in very large doses (amounts equal to 12 to 24 cups of coffee a day), and with bone growth problems when given in smaller doses.

Alcohol Avoidance

Alcohol is definitely harmful for the baby, no matter how much is consumed, especially during the first three months when the baby is forming.  There is also a definite correlation between the amount of alcohol drunk during pregnancy and the severity of the symptoms, and also a link with the risk of miscarriage and stillbirth.  Evidence shows that even pregnant mothers who only drink in moderation have a greater chance of miscarriage and low birth weight babies than those who do not.  Numerous studies have also shown that heavy drinking is extremely damaging for the baby and has the potential to lead to fetal alcohol syndrome.  Such babies have low birth weight, with a smaller head circumference and mental retardation is often present.  Some affected babies have malformed faces and congenital heart defects.

The current recommendation from doctors and health experts is that pregnant women should not drink at all. If the urge is too strong, one standard drink is the absolute maximum.  However, in the first few weeks of pregnancy, it is difficult to know that you are pregnant and this is a particularly crucial stage for the formation of the baby.  So, if you suspect that you are pregnant, or are planning to conceive, you should stay away from alcohol.  The risk of miscarriage doubles with more than two drinks per day.

High/Increased Protein Diet

Adequate protein intake can prevent preeclampsia, and a higher protein diet can often successfully reverse preeclampsia.

Aspartame (Nutrasweet) Avoidance

Dr Diana Dow Edwards, a researcher, was funded by Monsanto to study possible birth defects caused by the ingestion of aspartame.  After preliminary data showed damaging information about aspartame, funding for the study was cut off.  A separate genetic pediatrician at Emory University has testified that aspartame is causing birth defects.

In the book, While Waiting: A Prenatal Guidebook by George R.  Verrilli, M.D.  and Anne Marie Mueser, it is stated that aspartame is suspected of causing brain damage in sensitive individuals: a fetus may be at risk for these effects.  Some researchers have suggested that high doses of aspartame may be associated with problems ranging from dizziness and subtle brain changes to mental retardation.

Not recommended
Increased Fish Consumption

Based on the recommendations of the Environmental Working Group and the U.S.  Public Interest Research Group, it is recommended that shark, swordfish, king mackerel and tilefish, tuna, sea bass, halibut, marlin, pike, Gulf coast oysters and white croaker not be eaten by pregnant women and women of childbearing age who might become pregnant due to mercury contamination.  It also recommended that nursing mothers and young children steer clear of these fish.  In addition, the report says canned tuna, mahi-mahi, cod and pollack should not be eaten more than once a month.

"The widespread contamination of fish with mercury has given its reputation as 'brain food' a new and disturbing connotation.  Mercury is toxic to the developing fetal brain, and exposure in the womb can cause learning deficiencies and delay mental development in children."

A Center for Disease Control report finds that an estimated 375,000 babies being born each year at risk of neurological problems due to exposure to mercury in the womb.  The Mercury Policy Project report indicates that at least 10 percent of women of childbearing age have levels of mercury in their bodies that exceed what the U.S.  Environmental Protection Agency considers acceptable and this translates to nearly six million women.

Not recommended
Therapeutic Fasting

Fasting should be avoided during pregnancy.

Drug

GHB (Gamma-Hydroxybutyrate)

GHB induces "remarkable hypotonia" (muscle relaxation) [Vickers, 1969] and is now gaining popularity in France and Italy as an aid to childbirth.  GHB causes "spectacular action on the dilation of the cervix", decreased anxiety, greater intensity and frequency of uterine contractions, increased sensitivity to oxytocic drugs (used to induce contractions), preservation of reflexes, a lack of respiratory depression in the fetus, and protection against fetal cardiac anoxia (especially in cases where the umbilical cord wraps around the fetus' neck) [Vickers, 1969; Laborit, 1964].

Habits

Tobacco Avoidance

Smoking in pregnancy is very clearly linked to a higher risk of miscarriages, low birth weight babies and premature babies.  There is also a link to risks of stillbirths and babies dying in the first few weeks of life.  This is due to nicotine which decreases the amount of blood delivered to the fetus, therefore less nutrients and oxygen is received by the baby.

The current recommendation of doctors is for the mother to not smoke at all, however if the mother is having difficulty quitting, 3-6 cigarettes a day is the absolute maximum.  If you are a smoker, the best time to stop is before you get pregnant because the first few weeks of pregnancy are crucial to the development of the baby.  Also, you should encourage other members of the family to quit smoking or not to smoke in your presence because passive smoking may be damaging to the mother and fetus.  In addition, smoking around your new-born increases his/her risk of developing asthma and other respiratory disease.

Hormone

Not recommended
Topical Estrogen

There are essentially no reasons during pregnancy why any woman would be advised to take hormones.

Not recommended
Estrogen-balancing Medications

There are essentially no reasons during pregnancy why any woman would be advised to take hormones.

Not recommended
Estrogen Replacement

There are essentially no reasons during pregnancy why any woman would be advised to take hormones.

Not recommended
Melatonin

On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women.

Not recommended
Natural Progesterone

There are essentially no reasons during pregnancy why any woman would be advised to take hormones.

Lab Tests/Rule-Outs

Not recommended
Bone Scan

Due to concerns regarding radiation exposure to a fetus, bone scans are not generally recommended for women who are or might be pregnant.

Not recommended
Test Estrogen Level

Hormone levels fluctuate at different stages of pregnancy, making it difficult to isolate any underlying imbalances during this time.

Mineral

Calcium

Children of mothers who took calcium during pregnancy were still reaping the benefits seven years later in one Argentinian study.  Blood pressure was lower in these youngsters – especially among overweight children – than those in the non-supplement-taking group.  [Belizan JM, et al.  Brit Med J 1997;315(7103): pp.281-5] Taking calcium may also decrease a woman's chance of developing pre-eclampsia, pregnancy-related hypertension.  [Moutquin HM, et al.  Can Med Assoc J 1997;157(7): pp.907-19]

A growing baby acquires most of its calcium during the last trimester of pregnancy; an additional amount is needed during breastfeeding.  This translates into a greater need for calcium during and after pregnancy.  A pregnant woman who fails to consume adequate calcium -1,200mg per day is recommended – increases her risk of developing osteoporosis later in life, especially if she becomes pregnant again.  [Vandecandelaere M, et al.  Rev Med Interne 1997;18(7): pp.571-4]

Magnesium

Low magnesium levels are common among women suffering from severe nausea and vomiting, says Miriam Erick, M.S., R.D., dietetic manager of Clinical Obstetrics at Brigham and Women's Hospital in Boston.  Therefore, magnesium for these expectant moms is critical.  Magnesium can also help treat pregnancy-related leg cramps [Dahle LO, et al.  Am J of Obst & Gyn 1995;173: pp.175-180] and alleviate severe pre-eclampsia, a serious condition in which high blood pressure, edema and protein in the urine are present in pregnant women.  [Khan KS, Chien Pl.  Brit J Obst & Gyn 1997;104(10): pp.1173-9] Taking prenatal magnesium may also reduce risk for cerebral palsy and mental retardation among very low birth-weight infants.  [Schendel DE, et al.  J of the AMA 1996;276(22): pp.1805-10]

The U.S.  RDA is 320mg; magnesium is more important for later pregnancy but should be safe in small doses throughout pregnancy (around 200mg per day).

Iron

Iron is routinely prescribed for pregnant women during the second and third trimesters, when blood volume increases by 50%.  The growing baby is also making blood.  Hemoglobin, the blood component that carries oxygen to the cells, is composed in part of iron.  During pregnancy, your baby receives plenty of this critical mineral because your body absorbs iron more efficiently.  [Eskeland B, et al.  Acta Obstetricia et Gynecologica Scandinavia 1997;76: pp.822-8]

There is some controversy about whether iron supplementation is really needed or effective, except for women such as diabetics or those with anaemia, whose iron deficiency is a real threat.  [Lao TT, Tami KF.  Diabetes Care 1997;20(9): 1368-9] Iron supplementation for anemia often fails because women don't take iron long enough, say researchers at the University of California, Berkeley.  They suggest beginning iron supplementation before conception and continuing until breastfeeding is finished.  [Viteri FE.  Nutr Rev 1997;55(6): pp.195-9]

It is preferable to get your iron in natural foods.  Iron supplements may cause nausea and constipation, making the common discomforts of pregnancy worse.  Too much iron is also bad for the circulation.  If you do need to take iron supplements on doctor's advice, iron chelate is better tolerated by the body and is available from chemists.  The U.S.  RDA is 30mg.

Zinc

Inadequate amounts of zinc can lead to central nervous system and other malformations, small-for-age babies and miscarriage.  Adding a moderate dose of zinc to your prenatal supplement regimen may also benefit your baby's immunity.  [Lastra Md, et al.  Arch of Medl Res 1997;28(1): 67-2]

The U.S.  RDA is 15mg.

Iodine

Iodine deficiency during pregnancy and early infancy can result in cretinism (irreversible mental retardation and severe motor impairments).

Selenium

A small study of infertile women and women with a history of miscarriage suggests that low levels of magnesium may impair reproductive function, and may contribute to miscarriage.  Oxidation, a process that is damaging to cell membranes, can lead to loss of magnesium.  The same study suggests that the antioxidant selenium protects the cell membrane, thereby maintaining appropriate levels of magnesium.  The authors of the study suggest taking both magnesium and selenium supplements.

Women who have miscarried have lower levels of selenium than women who carry a pregnancy to full term.  Although the authors of the above-mentioned study do not specify the exact amount to take, the recommended doses are generally 300 to 400mg per day of magnesium and 200mcg per day of selenium.

Nutrient

DHA (docosahexaenoic acid)

According to an article in the American Journal of Clinical Nutrition, healthy full-term infants who are breast-fed for at least four months show greater visual perception skills at early childhood than their bottle-fed counterparts.  Testing revealed differences in the maturity of the brain's visual cortex, an important stage in a child's neurological development.  [Am J Clin Nutr 2001;73(2): pp.316-22]

Of the 15 factors analyzed that could potentially influence that rate of visual development in infants, breastfeeding for 4 months or more independently had the greatest positive impact.  The only other factor in this study that independently affected the children's stereoacuity at 3.5 years was the mother's consumption of oily fish during pregnancy.

This supports the idea that children may develop improved visual acuity and achieve a higher verbal IQ when breast-fed because they receive a fatty acid, docosahexaenoic acid (DHA) found in breast milk [Arch Dis Child Fetal Neonatal Ed 2001;84: pp.23-7].  The amount of DHA found in breast milk increases with the consumption of oily fish or when otherwise supplemented and decreases when less DHA is consumed.  Indeed, testing has revealed that a child's visual acuity directly correlated with the mother's level of DHA in her red blood cells.

During the last trimester of a pregnancy the mother transfers to her fetus much of the DHA needed for the development of its brain and nervous system.  As a consequence, she may lose as much as 3% of her brain mass during this time and therefore supplemental DHA may help prevent postpartum depression and ensure an adequate supply for the nursing baby.

The DHA content in the mother's diet reflects the amount of DHA passed on to the baby.  If the baby is not breastfed at all, it receives much less DHA, thus hindering and impairing mental and visual acuity.  DHA levels of premature infants are especially low since they miss much of that last trimester.  Premature babies are also more likely to be bottle-fed.

Vegan diets are devoid of EPA and DHA, while vegetarian diets provide small amounts in dairy products.  Vegetarian and vegan women should therefore ensure their diets include sources of alpha-linolenic acid (ALA), the precursor of EPA and DHA, during pregnancy and breastfeeding.  Supplemental DHA may be appropriate in some cases.  It is suggested that vegans use plant oils with a low ratio of linoleic acid (Omega-6) to ALA (Omega-3), such as flax or canola, as a higher ratio may inhibit the conversion of ALA to DHA..

Essential Fatty Acids

Adequate and balanced essential fatty acid intake is important for the optimal neurologic development of the baby.

Vitamins

Folic Acid

The need for this vitamin more than doubles during pregnancy.  This is often not met by the diets of pregnant women, so a supplement of 400mcg to 1mg per day of folic acid is recommended throughout pregnancy.

In 1992, the U.S.  Public Health Service recommended that all women of childbearing age consume additional folic acid.  This means that increased consumption of folic acid is crucial not only during pregnancy, but also before conception.  It has been estimated that if all women of childbearing age met this allowance, the number of neural tube defect cases in the United States could decrease by at least 50%.  [CDC.  Morbidity and Mortality Weekly Report, 1992; 41(RR-14)]

Although foods such as dark-green leafy vegetables provide a reasonable source of folic acid, most women don't reach the recommended 400mcg through diet alone.  [Johnston RB, Staples DA.  1997.  J Am Med Assoc 1997;278 (11): pp.892-3]

Neural tube defects: (spina bifida): In one study, women who consumed 400mcg of folic acid per day cut in half their chances of having babies with birth defects of the brain and spinal cord, such as spina bifida.  Whether a baby develops these defects is determined in the first days after conception (the critical time may be day 27-28) – perhaps before a woman knows she is pregnant.

In another study, one-half of women who had delivered children with spina bifida or anencephaly were found to have had a poor diet during the pregnancy which ended with a child with a neural tube defect.  103 of these women received dietary counseling prior to their next pregnancy while 71 controls received no counseling.  Of those who improved their diet, all delivered normal children, while all 8 out of 186 newborns with NTD were born to women who ate a poor diet during their first 6 months of pregnancy [Laurence KM.  Nutr Health 2( 3/ 4), 1983].

Scientists currently theorize that women who give birth to babies with neural tube defects are less able to convert homocysteine to methionine, and that high levels of homocysteine may cause birth defects.  Folic acid, along with vitamin B12, is required for this biochemical conversion, as well as new tissue production and growth in both baby and mother.

Downs: Mothers with a genetic abnormality that hinders how the body processes folic acid were 2.6 times more likely to have a child with Down syndrome than mothers without that genetic defect.  Millions of women appear to have this genetic abnormality, yet the risk of having a child with Down syndrome actually is small – one in 600 births.  If you have this mutation and you happen to have a very poor diet, it magnifies the problem; the researchers call this a gene-nutrient interaction.  The March of Dimes estimates there are 250,000 Americans with Down syndrome.  (American Journal of Clinical Nutrition October 1999)

Cleft palate: Only high pharmacological doses (6mg per day) of folic acid in the critical period of the primary and the secondary palate development seem to be effective for the reduction of clefts.  Doses less than 1mg of folic acid cannot reduce these birth defects.

Case Report: After giving birth, a woman developed severe depression, confusion, disorientation and hallucinations.  Over the next 19 months, trials with numerous medications and electroshock therapy were unsuccessful.  Folic acid deficiency was diagnosed and folate supplementation was started.  In 10 days, she was completely cured.

Vitamin B-Complex

Many naturopathic and other doctors suggest using vitamin B complex (50mg per day) with additional vitamin B6 and folic acid (800 to 1000mcg per day) for women planning to become pregnant and for those who are pregnant.  These preventive measures are supported by studies that suggest a connection between recurring miscarriages and problems metabolizing methionine and homocysteine in the body.  Folic acid, vitamins B6 and B12, and betaine all play a role in the proper use of these compounds.

Vitamin E

Several studies imply that harmful free radicals called lipid peroxides contribute to pre-eclampsia [Khan KS, Chien Pl.  Brit J of Obst & Gyn 1997;104(10): pp.1173-9], and that women with this condition are low in the antioxidants that combat them.  [Ziari SA, et al.  Am Jl of Perinat 1996;13(5): pp.287-91]

The U.S.  RDA is 10mg.

Vitamin C (Ascorbic Acid)

Several studies imply that harmful free radicals called lipid peroxides contribute to preeclampsia [Khan KS, Chien Pl.  Brit J of Obst & Gyn 1997;104(10): pp.1173-9], and that women with this condition are low in the antioxidants that combat them.  [Ziari SA, et al.  Am Jl of Perinat 1996;13(5): pp.287-91]

In one study of over 300 consecutive births, the mothers were given 5gm of vitamin C in the first trimester, 10gm in the second and 15gm in the third.  Their babies were all born very healthy and the nurses often commented that the vitamin C babies and mothers were generally healthier than the non-vitamin C participants.

The U.S.  RDA is 70mg.  NOTE: Be very careful to avoid high doses.

Vitamin K

The U.S.  RDA is 65mg.

Vitamin D

The Children's Memorial Hospital in Chicago studied five vitamin D-deficient infants; at least two cases were caused by low vitamin D levels during pregnancy.  Health problems ranged from seizures and growth failure to rickets.  [Daaboul J, et al.  J of Perinat 1997;17(1): 10-4] Congenital cataracts have also been linked to low levels of vitamin D.  [Blau EB.  The Lancet 1996;347: p.626] Other research points to vitamin D as a possible adjunct therapy for premature babies with respiratory distress syndrome [Nguyen TM, et al.  Am J of Physiol 1996; 271(3): L392-9] and for women with gestational diabetes.  [Rudnicki PM, Molsted-Pedersen L.  Diabetologia 1997; 40(1): 40-4]

The U.S.  RDA is 400 IU or 10mg.

Vitamin B6 (Pyridoxine)

Vitamin B6 is necessary for optimal brain development and is an essential coenzyme for neurotransmitter synthesis.  [Gerster II.  Z.  Ernahrungswiss 1996;35(4): pp.309-17] One animal study found that vitamin B6 helped prevent the formation of cleft palates.  [Jacobsson C, Granstrom G.  Cleft Palate Craniofacial J 1997;34(2):95-100] Like magnesium, vitamin B6, together with vitamin B1, may also ease pregnancy-related leg cramps.  [Avsar AF, et al.  Am J of Obst & Gyn 1996;175(1):233-4]

The U.S.  RDA is 2.2mg.

Not recommended
Bioflavonoids

Quercetin should be avoided during pregnancy.

Not recommended
Vitamin A

Supplemental vitamin A palmitate (retinol) is contraindicated during pregnancy since it has been tied to birth defects.  NOTE: Be extremely careful to avoid high doses during pregnancy or if there is a likelihood of becoming pregnant soon.

Report by The Analyst™
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Health problems rarely occur in isolation or for obvious reasons

Your body is a highly complex, interconnected system.  Instead of guessing at what might be wrong, let us help you discover what is really going on inside your body based on the many clues it is giving.

Our multiple symptom checker provides in-depth health analysis by The Analyst™ with full explanations, recommendations and (optionally) doctors available for case review and answering your specific questions.

KEY

Weak or unproven link: may be a sign or symptom of; may suggest; may increase risk of; sometimes leads to
Weak or unproven link:
may be a sign or symptom of; may suggest; may increase risk of; sometimes leads to
Strong or generally accepted link: is often a sign or symptom of; often increases risk of
Strong or generally accepted link:
is often a sign or symptom of; often increases risk of
Definite or direct link: strongly suggests; increases risk of
Definite or direct link:
strongly suggests; increases risk of
Definitely or absolutely counter-indicates: decreases risk of; greatly reduces the likelihood of
Definitely or absolutely counter-indicates:
decreases risk of; greatly reduces the likelihood of
May be useful: may help with
May be useful:
may help with
Moderately useful: often helps with
Moderately useful:
often helps with
Very useful: is highly recommended for
Very useful:
is highly recommended for
Caution: is sometimes not recommended for
Caution:
is sometimes not recommended for
Often counterindicated: is often not recommended for
Often counterindicated:
is often not recommended for
Should be avoided: is NOT recommended for
Should be avoided:
is NOT recommended for