FOOD SAFETY IS IMPORTANT FOR EVERYONE BUT especially for your pregnant patients and their unborn children. More than 6.5 million women in the United States are pregnant annually. During pregnancy, changes in hormones cause a woman’s immune system to become suppressed so that it is harder to fight off infections.1
Because a mother’s health behaviors have direct effects on the health of her baby, expectant mothers receive a lot of health information.1 Along with nutrition concerns, a growing topic of importance is food safety during pregnancy. Most women know that avoiding certain medications, smoking and alcohol can reduce the possibility of serious birth defects, but what about avoiding foodborne pathogens? According to the Centers for Disease Control and Prevention (CDC), 48 million people get sick, 128,000 are hospitalized and 3,000 die from foodborne infection and illness in the United States each year. Pregnant women and their unborn children have a higher risk of developing certain foodborne illnesses because of the hormonal changes that occur during pregnancy.1 These changes suppress the mother’s immune system, thereby increasing the chance of infection from certain foodborne pathogens.
The pathogens that are of greatest concern during pregnancy are Listeria monocytogenes, Toxoplasma gondii, Brucella species, Salmonella species and Campylobacter jejuni.2 Certain organisms can cross the placenta and increase the fetus’s risk of becoming infected. Infection can result in miscarriage, stillbirth, premature labor or severe complications for the baby.1 The CDC report that pregnant women are 14 times as likely as other healthy adults to get listeriosis. About one in three cases of listeriosis occurs in pregnant women, which means more than 800 pregnant women in the United States get listeriosis each year. Because pregnant women are at high risk for infection from certain pathogens, they are advised to avoid foods that may be contaminated with these harmful pathogens.
Symptoms of Foodborne Illnesses
You may get sick very soon after eating contaminated food or symptoms may not occur for days or weeks. This depends on what type of harmful substance is in the food. These symptoms can include:
Certain foods should be actively sought out during pregnancy (see Figure 1), while other foods should be minimized and/or avoided (see Figure 2).1,3
Supplementation in Pregnancy
Most medical organizations now recommend a daily multi-vitamin/multi-mineral for everyone. Pregnant women are no exception. Indeed, research has shown that vitamin supplementation can improve pregnancy outcomes while reducing nausea and morning sickness.9 Vitamin D helps you to develop strong and healthy bones and it does the same for your developing baby.10 The Endocrine Society states that the recommended daily allowance of vitamin D for pregnant women is 1,000 IU/day, with upper limits being 10,000 IU/day.10
Note: The author strongly encourages you to advise your pregnant patients to check with their obstetricians about foods that are best for them during their pregnancy.
2. Smith JL. Food borne Infections during Pregnancy. J. Food Protection. 1999. 62: 818-829.
3. Public Health: Foodborne Illnesses in Pregnancy. www.publichealth.va.gov/infectiondontpassiton/womens-health-guide/food-borne-illness/index.asp#sthash.LsHHt30z.dpuf.
4. Innis SM. Friesen RW. Essential n-3 fatty acids in pregnant women and early visual acuity maturation in term infants. Am J Clin Nutr. 2008;87:548–557.
5. FSIS-USDA. 2010. Protect Your Baby and Yourself From Listeriosis.www.fsis.usda.gov/PDF/ProtectThYourThBaby.pdf.
6. Jackson KA. Iwamoto, M. Swerdlow, D. Pregnancy-associated listeriosis. Epidemiol. Infection. 2010. 138:1503-1509.
7. Smith JL. Long-term consequences of foodborne toxoplasmosis: Effects on the unborn, the immunocompromised, the elderly, and the immunocompetent. J. Food Protection. 1997. 60:1595-1611.
8. March of Dimes. www.marchofdimes.com/pregnancy/caffeine-in-pregnancy.aspx.
9. American Pregnancy Association. Surviving Morning Sickness. http://americanpregnancy.org/pregnancyhealth/survivingmorningsickness.html.
10. Holick MF. Binkley NC. Bischoff-Ferrari HA. Gordon CM., et al. Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30.