Other risks in pregnancy

You can’t wrap yourself up in cotton wool for the whole 40 weeks of pregnancy, but there are simple things you can do to avoid some risks. I’ve covered guidelines for eating fish and meat, the risk of Salmonella and Listeria. This page completes the pregnancy series and looks at those risks that don’t fall under any of the above categories.

Toxoplasmosis

This is also covered on the page about meat, but it’s not just meat that is a risk. Contaminated soil can get onto vegetables, so they should be washed well. The NHS site also advises avoiding direct contact with cat poo, avoiding emptying litter trays but making sure they are changed regularly, and wearing gloves while gardening. There is also a small risk of toxoplasmosis from contact with the afterbirth of sheep, so pregnant women are advised to avoid lambing, contact with newborn lambs and milking ewes.

Alcohol

This is possibly the most controversial one, and health professionals rarely give a straight answer. The current guidance is that the safest approach is to avoid alcohol altogether. While it’s clear that regular high alcohol consumption in pregnancy can have devastating effects, the research into light to moderate drinking is less clear. One of the problems is that the effect of alcohol consumption is altered depending on when in the pregnancy it is consumed, how much, how often, the age and genetics of the mother, how many times she has been pregnant and her socioeconomic status. The socioeconomic status one isn’t intuitive – but likely is because a rich (not necessarily monetarily) childhood can mask minor difficulties caused by light alcohol consumption, and conversely a difficult childhood may exacerbate them. That all makes it pretty hard to write an all-encompassing guideline. Here’s a really interesting review of the literature to date.

Caffeine

A hard one for many to give up, the current advice is to limit it to 200mg a day (around one strong coffee, 2 weaker ones, 3 instant coffees or cups of tea; though there is some evidence that having all your allowance in one strong coffee is not a good idea). Excessive caffeine has been associated with pregnancy loss (e.g this study and this one), low birth weight babies, and lower IQ, however in many cases the effect was marginal and results difficult to interpret.

Vitamins and supplements

I mentioned vitamin A on the “eating meat” page – the current guidelines are to avoid high sources of vitamin A. This means that pregnant women need to check that any vitamins or supplements they are taking do not contain vitamin A.

Food poisoning

It is impossible to avoid all risks of food poisoning. Most food poisoning, while unpleasant, won’t be serious for you or your unborn child. Here are some ways to reduce the risks (whether you’re pregnant or not):

  • Don’t eat rare beef burgers. Most food poisoning organisms can only affect the outside of a piece of beef, so if you cook the outside you will kill any germs. But, when you mince raw meat, you mix the inside and the outside of the meat, so the germs could be anywhere. If you then make a burger with them, the inside of that burger could well include food poisoning organisms such as E. coli.
  • Wash your fruit and veg (even if it’s already been washed). Washing fruit and veg won’t get rid of all the nasties (some tricky bugs can internalise in fruit/veg) but will reduce the number of them.
  • Practice good food hygiene. Make sure meat is at the bottom of your fridge, wash your hands, don’t wash meat. Wash chopping boards and knives between food types, don’t eat things past their used by date (past the best before should be OK though). Make sure food is stored at the correct temperature and cooked correctly.
  • Practice good personal hygiene
  • Avoid raw seafood
  • Avoid raw or undercooked eggs, particularly if you’re eating out
  • Be careful with raw chicken and wash your hands after touching the packaging (Campylobacter can be present on the outside of packaging) and avoid dishes where chicken may not have been thoroughly cooked (e.g. chicken liver parfait).
  • Be cautious of reheating rice – To avoid Bacillus cereus toxins only eat reheated rice if it has been cooled quickly and stored at refrigerator temperature. Bacillus cereus spores may survive the initial cooking. If the rice is left at room temperature they can turn into bacteria and produce toxins. These toxins aren’t killed by subsequent cooking and can make you ill.

Farms

Obviously for some, farms are unavoidable. People who live or work on farms get pregnant, after all. However, sheep may carry several diseases that are a risk for pregnant women. The NHS advise that pregnant women do not help deliver lambs, milk ewes, have contact with newborn lambs. This is because sheep and lambs can carry Listeria, Toxoplasma, Chlamydia and Q fever, all of which may be a risk to an unborn baby. Pregnant women visiting farms should also be aware of the risk of other infections such as E. coli. I’m going to write about infections on farms next week, so look back here for that information soon!

What did I do?

Though I decided my risk of first toxoplasmosis infection was low, I avoided changing our cats litter tray (any excuse!) and wore gloves when digging in the garden. I was also cautious of sand pits in my second pregnancy (cats like to poo in them, but my daughter loved them). I did have the occasional alcoholic drink, though only on social occasions, and only one (a glass of champagne at Christmas, for example). I drank decaf coffee, though did eat a fair amount of dark chocolate, which also has some caffeine in. I took reasonable measures to avoid food poisoning where I could, and practiced good hand hygiene on farms, avoiding the lambing season completely. And one thing that goes without saying really: I avoided smoking and illicit drugs!

This isn’t a complete list of everything that may affect a pregnancy, but hopefully it goes some way to explain some of the risks. I will add to it as time goes on, so let me know if I’ve missed something obvious!

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