Articles Index-Babies / Pregnancy
 
Pregnancy - part 2
 
Last time we looked at the different problems that women can encounter during pregnancy and how they might be helped with a natural approach. This article is the second part of that series.
 
Weight - women are often worried about gaining weight during pregnancy, or they have begun the pregnancy at a heavier weight than they would have liked. Under no circumstances should a woman diet during pregnancy. If she crash diets she will deprive herself and the baby of valuable nutrients. Her body will also detoxify (losing toxins stored in fat throughout the body) and these toxins will pass though the baby before they are excreted.
 
If the woman eats a good, nutritious diet, she will lose any unnecessary weight naturally. The way to lose weight during pregnancy is to eat more healthily and any excess weight will come off. A healthy weight gain during pregnancy is considered to be not more than 15kg (33lb) and also not less than 5kg (11lb). If she finds that she is well above or below this range, the woman needs to talk to her doctor. Some women find that they gain a great deal of weight, but lose it after the pregnancy with ease. If this is the case for previous pregnancies, and has not presented problems, then she need not worry. Every woman is different.
 
The most important thing a woman can do to maintain a healthy weight is to ensure that her blood sugar is balanced by eating regularly. If she misses meals in an attempt to restrict calories, she will end up craving sweets and chocolates because her blood sugar has dropped too low.
 
She should reduce her intake of concentrated fruit juices, even unsweetened brands. These juices may have some nutritional value, but they lack fibre and many women have found that they can cause weight gain because they cause the blood sugar to fluctuate. Juice should always be diluted (half and half) with water. She should eat slowly and chew well. It takes 20 minutes for her brain to register that she is full, so if she eats slowly she can avoid overeating.
 
Stretchmarks
Women can be concerned about stretch marks which can appear as weight is put on during pregnancy. Use a mixture of wheatgerm oil and vitamin E to massage into the skin once a day to improve the elasticity.
 
Pre-eclampsia
This is a condition that can affect women in late pregnancy. It is characterised by high blood pressure, protein in the urine and swelling in the hands and feet. If the pre-eclampsia is allowed to continue unchecked, headaches can develop and blood pressure can increase even further.
 
Bed-rest is required if this condition is diagnosed, which can help to lower the blood pressure. However, if symptoms continue to get worse, her doctor may decide to induce an early birth, or perform a Caesarean section. Untreated pre-eclampsia may develop into eclampsia, which can be fatal. In fact, 10% of women who develop eclampsia will die.
 
The risk to the baby is even greater - 25% of babies will die. The medical cause of this condition is unknown, but increased oxidative stress and reduced antioxidant defences have been suggested to play a part.In 1999, The Lancet published results of the first trial into whether vitamin supplements were effective in preventing pre-eclampsia. Half of a group of pregnant women, some with a history of the condition and others with an abnormal blood flow to the placenta, were given vitamin E and vitamin C supplements. The other half were given a placebo (dummy tablet). The group who took the vitamins had a 76% reduction in pre-eclampsia, compared to those taking the placebo. At least four other studies over the last few years have confirmed the link between low levels of antioxidants and a higher risk of pre-eclampsia.
 
Then in June 2006, the same research group published a trial which seem to contradict the first one. It recruited 2,400 high-risk pregnant women randomised to receive vitamin C (1000mg) and vitamin E (400iu) or placebo. Treatment with the antioxidants did not reduce the incidence of pre-eclampsia and more low birthweight babies and stillbirths were born to women taking the vitamins.
 
These results seem disappointing, but this 2006 trial had some drawbacks in that the study population included women with a number of medical problems including diabetes, previous pre-eclampsia, chronic hypertension, antiphospholipid syndrome, renal disease, obesity and multiple births.
 
Also, at the beginning of the trial, women were asked to provide a blood sample to ascertain pre-randomisation levels of vitamin C and vitamin E. But women were not excluded if they did not provide this sample and samples were obtained for only half of the women. Plasma concentrations of vitamin C were significantly lower throughout the pregnancy for those who took placebo and developed pre-eclampsia than in women who did not. About 25% of the women in both arms of the study took multivitamins and of those women, birthweight was significantly higher than for those women not taking any supplements. Two important points come out of this trial. The first is that either all women in the trial should have been taking the same multivitamins or none should have taken any additional nutrients other than the treatment antioxidants, so that any effects would be due solely to the treatment and not to any interactions. The second point, which is more important, is that blood samples should have been taken for all the women pre-randomisation to ascertain baseline levels and then to track the levels throughout the trial. This was not done consistently in this trial and it is possible that the risk of pre-eclampsia is different in those women who are deficient before supplementation. This is borne out by the fact that in this trial the plasma concentrations of vitamin C at baseline were higher than for the similar cohort of women used in the 1999 trial which showed that antioxidants reduced the incidence of pre-eclampsia.
 
In another study in 2006, looking at the effects of women taking a pregnancy multivitamin compared to non-users, users showed a 45% reduction in pre-eclampsia risk compared to non-users.
 
With pre-eclampsia, research has also focused on homocysteine. Homocysteine should, under normal circumstances, be detoxified by the body with the help of folic
 
acid, vitamin B6 and vitamin B12. Women with pre-eclampsia have been shown to have elevated blood levels of homocysteine. Other research has shown that women with the lowest levels of Omega-3 fatty acids are more likely to have pre-eclampsia. Both vitamin E and the Omega-3 essential oils help to prevent blood clotting and abnormal blood flow to the placenta.
 
Preterm births
Preterm births are on the increase. Research published in the British Medical Journal in 2006 showed that the rate of spontaneous preterm births in low-risk women increased by 51% from 1995 to 2004. The impact of preterm birth is enormous resulting in 75% of neonatal deaths and the majority of neonatal intensive care admissions. With 1 in 3 survivors beyond 32 weeks having education and behavioural problems by the age of seven, anything that can be done to reduce this risk is important.
 
A deficiency of vitamin C during pregnancy is a possible risk factor for premature rupture of the chorioaminiotic membranes (PROM). Collagen is important for the maintenance of the chorioaminiotic membranes and deficiencies in vitamin C can result in defective collagen synthesis. One study looked at the effectiveness of daily supplementation of vitamin C in preventing PROM. Women in their 20th week of gestation were randomised to vitamin C 100mg per day or placebo. The incidence of PROM was 24.5% in the placebo group compared to 7.69% in the vitamin C supplemented group.
 
A combination of vitamin C (500mg/day) and vitamin E (400iu/day) was used in another randomised controlled trial of women admitted to hospital between 26 to 34 weeks of pregnancy with premature rupture of the membranes. Both groups were also given the standard medication in the first 24 hours after admission together with broad spectrum antibiotics. In the supplemented group there was a significant difference in a longer time before they actually delivered.
 
Low consumption of fish has been found to be a strong risk factor for both preterm delivery and low birth weight, with women who never eat fish having a 7.1% risk of having a preterm baby compared to a 1.9% chance for women who ate fish once a week. Supplementing with fish oil (2.7g) per day from 30 weeks, resulted in a longer gestational period and increased birth weight. Other research shows that women who are deficient in zinc can go into labour prematurely.
 
Because preterm labour has been linked to vaginal infections, research has also focused on the use of probiotics. Oral lactobacilli strains can colonise the vagina and control pathogens including Gardnerella vaginalis and Escherichia coli. The use of probiotic drinks are not advised as these have a high added sugar content which is counter-productive for controlling bacteria and yeasts.
 
Dr Marilyn Glenville PhD is the UK's leading nutritional therapist specialising in female hormone problems. She is President Elect of the Forum for Food and Health at the Royal Society of Medicine and a registered nutritionist. Dr Glenville is speaking at the CAMEXPO at Excel on Saturday 6 October on Fat around the Middle so come along and earn CPD points. http://www.marilynglenville.com
 
SepOct 07
Back