In preparing for pregnancy, self-care to prevent complications is vitally important for both mother and child. Among the USA’s mothers-to-be, we are seeing a rise in gestational diabetes. Currently, 200,000 women are newly diagnosed each year.
Gestational diabetes leads to a greater risk of developing Diabetes Type II (insulin resistance) for the young mother, shortly following her pregnancy. Furthermore, there is considerable risk to the infant, including preterm birth, an enlarged heart, nervous system dysfunction, respiratory difficulties and abnormal blood sugar regulation.
Reasonable and effective lifestyle changes to prevent gestational diabetes can be initiated before and during pregnancy, ensuring greater health for mother and child. A recent study published through NIH revealed yet another easy and non-invasive method toward decreasing this risk: reduction in dietary animal fats.
According to the study, published in the American Journal of Clinical Nutrition, a higher dietary intake of animal fats and cholesterol is linked to a greater risk of developing gestational diabetes. Even with other lifestyle changes in place, such as increased exercise, the link remains significant. Also important was the finding that other non-animal dietary fats did not increase the risk of mothers-to-be developing gestational diabetes.
This study’s findings reinforce the importance of using everyday changes in diet, activity and general lifestyle to prepare for pregnancy and future health. Speak with your doctor about changes that could serve you and your future family best.
Dr. Kaley Bourgeois
High animal fat diet increases gestational diabetes risk. NIH News, Wednesday, January 25, 2012
Care of the infant of the diabetic mother. Curr Diab Rep. 2012 Feb;12(1):4-15.
For young women living with Lupus, becoming a mother can be a challenge both emotionally and physically. As the disease progresses, there is an increased risk of pregnancy complications such as miscarriage and preeclampsia. Furthermore, pregnancy has been known to increase the risk of worsening symptoms and disease flares for the expectant mother.
A recent study, spotlighted by the National Institute of Health earlier this month, suggests a healthy pregnancy and birth may not be far from reach for hopeful young women living with Lupus. If general health is supported prior to conception, and antibodies are reduced such that there is low disease activity, there is a significant decrease in risk of pregnancy complications. Disease flares, especially, are reduced.
While lower Lupus activity during pregnancy lessens risk to both mother and child, the route taken to stabilize the disease is just as important. The conventional treatment of Lupus involves immunosuppressive medications that are harmful to a developing fetus. Methotrexate, commonly used to treat Lupus, is known to cause birth defects and cannot be used during or after conception. Corticosteroids, conventionally given to pregnant mothers to reduce a disease flare, have an unknown effect on the fetus and should also be avoided. All immunosuppressive medications increase the risk of infection for the mother, and therefore the child.
Complementary and alternative medicine is often used in treatment of Lupus and other autoimmune conditions, and may offer fewer side effects for mother and child. Below is an example of some research-based treatment options that should be considered in the treatment of Lupus before conception:
High Dose Vitamin D
Another study shared by NIH revealed high-dose vitamin D therapy to boost general immune function, while reducing activity of autoimmune cells, thereby reducing Lupus activity levels. As vitamin D is known to play a significant role in the brain development of a fetus, assessing for adequate levels in any future mother is important.
Omega-3 Essential Fatty Acids
Dietary supplementation of omega-3 fatty acids has a therapeutic effect on Lupus activity, as well as offering cardiovascular protection and benefitting fetal development.
DHEA is a mild corticosteroid made naturally in the body, and found to be low in Lupus patients. Supplementation to balance hormone deficiencies prior to conception may help to reduce symptoms and disease activity by controlling excessive inflammation.
Work with your healthcare provider to create the appropriate treatment plan for yourself and your future child. There are many options available for addressing autoimmune disease and supporting your overall health.
Questions? Feel free to contact us at (503) 747-2021.
Dr. Kaley Bourgeois
-Pregnancy Safe for Most Women with Lupus: Study. Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118393.html
–Vitamin D, Interferon Alpha Vaccine Show Promise Against Lupus, Nov 7, 2011. MedlinePlus, US National Library of Medicine-NIH, http://www.nlm.nih.gov/medlineplus/news/fullstory_118395.html
–A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus. Ann Rheum Dis. 2008 Jun;67(6):841-8. Epub 2007 Sep 17.
–Dehydroepiandrosterone suppresses interleukin 10 synthesis in women with systemic lupus erythematosus. Ann Rheum Dis. 2004 Dec;63(12):1623-6.
The need for folic acid supplementation in pregnancy to prevent neural tube defects is already well known by both physicians and many mothers-to-be. In addition to preventing these birth defects, there are multiple reasons for young, fertile women to take folic acid before and during pregnancy, all of which are equally important and beneficial for their future child. The following discussion highlights just a few of these reasons.
Recent studies suggest maternal folic acid supplementation may help to:
-Prevent delays in childhood speech development
-Decrease childhood behavioral difficulties
-Support fertility in both partners
-Prevent pre-term labor
Printed in a recent addition to the Journal of American Medical Association, an article by clinical psychologist Christine Roth discussed the connection between low maternal folic acid and childhood speech development:
“Maternal use of supplements containing folic acid within the period from four weeks before, to eight weeks after conception was associated with a substantially reduced risk of severe language delay in children at age 3 years”
These findings support current recommendations for young, fertile women to take folic acid before and during early pregnancy. Since folic acid deficiency is known to disrupt nervous system development early in pregnancy, it is not surprising to find that there may be other symptoms of an impaired nervous system, such as delayed speech. There is great potential for other neurological symptoms to arise in mothers not getting enough folic acid.
Early data from another study, this one published in the Journal of Child Psychology and Psychiatry, suggests more behavioral difficulties arise in children (average age of 8 years) whose mothers had a lower level of folate during early pregnancy. Specifically, these children were at greater risk for hyperactivity and difficulties with peers.
Folic acid supplementation doesn’t only apply to future moms. Both women and men should consider supplementing before pregnancy, as it is an essential part of the reproductive system for both sexes. Research suggests a deficiency in folate (the body’s form of folic acid) may impair fertility for both partners, as it is an important nutrient in sperm and egg maturation.
Another widely studied basis for taking folic acid is to prevent early labor. In one such study of moms, all with varied but normal folate levels, those with higher levels were as much as 60% less likely to give birth to a pre-term baby. With so many known health risks for preemies (learning disabilities, delayed development, death, etc.), taking folic acid should be a step every women takes before starting her family.
According to the National Institutes of Health, foods richest in folic acid include:
Legumes: Black-eyed peas, Great Northern beans, Lentils, Peanuts
Vegetables: Spinach, Green peas, Broccoli, Asparagus
Common causes of folate deficiency include:
Pregnancy and breastfeeding
Medications such as Metformin
Potential symptoms of folate deficiency:
Loss of appetite
If you are planning on beginning a family, or you are already pregnant, speak with your healthcare provider today about the right supplements for you.
Dr. Kaley Bourgeois
NIH: Office of Dietary Supplements, http://ods.od.nih.gov/factsheets
MedlinePlus–Healthday, Folic Acid in Pregnancy May Prevent Kids’ Language Delays, 2011
Scholtz, W., et al., Lower maternal folate status in early pregnancy is associated with childhood hyperactivity and peer problems in offspring., J Child Psychol Psychiatry, 2010 May; 51(5): 594-602.
Ebisch, I., et al., The important of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility., Oxford Journal: Human Reproductive Update, vol. 13, issue 2, pp. 163-174.
Bodnar, LM., et al., Maternal serum folate species in early pregnancy and risk of preterm birth., Am J Clin Nutr. 2010 Oct; 92(4): 864-71.