Pregnancy is often an emotional journey, filled with anticipation and, at times, anxiety. The first trimester, in particular, can be a period of heightened concern regarding miscarriage. While miscarriages are unfortunately common, understanding the factors that can influence pregnancy health empowers expectant parents to make informed choices. This article delves into the role of diet in potentially reducing the risk of miscarriage, drawing on scientific evidence and expert recommendations.
Understanding Miscarriage
A miscarriage is defined as the loss of a pregnancy before the 20th week of gestation. The majority of miscarriages occur early in pregnancy, often before a woman is even aware she is pregnant. While the experience is devastating, it's crucial to remember that miscarriages are rarely caused by something the woman did or didn't do.
Common Causes
- Chromosomal Abnormalities: The most common known cause of early miscarriage is chromosomal abnormalities in the developing baby. Chromosomes, which are blocks of DNA containing instructions for development, can sometimes develop incorrectly, leading to an imbalance in the number of chromosomes. These abnormalities typically occur by chance and are not preventable.
- Condition of The Uterus: Some women have fibroid tumors in the uterus which interfere with the development of the embryo.
- Unexplained: Nearly 50% of miscarriages have no identifiable cause.
It’s important to note that miscarriages are rarely caused by lifestyle choices.
Risk Factors
Several factors can increase the risk of miscarriage, some of which can be modified through lifestyle choices:
- Maternal Age: The risk of miscarriage increases with maternal age, especially after age 35.
- Smoking: There is some evidence that suggests that partners can also increase their partner’s risk of miscarriage by smoking during their partner’s pregnancy or even during the time leading up the pregnancy. It’s not clear whether this is because of the risk of second-hand smoke alone, or because smoking also affects sperm.
- Alcohol and Drug Use: Using illegal drugs or drinking heavily during pregnancy increases your risk of miscarriage. There is no amount of alcohol that is considered ‘safe’ to drink during pregnancy. The Chief Medical Officers for the UK recommend that pregnant women don’t drink any alcohol at all.
- Weight: Having a BMI (body mass index) of under 19 or over 25 before pregnancy can increase the risk of miscarriage.
- Infections: There are some things you should avoid because of the risk of infection.
- Caffeine: High levels of caffeine during pregnancy has been linked to miscarriage and low birth weight. Consuming too much caffeine while you are trying to conceive may also increase the risk of miscarriage.
- Medical Conditions: Certain medical conditions, such as uncontrolled diabetes, thyroid disorders, and autoimmune diseases, can increase the risk of miscarriage.
- Previous Miscarriage: Women who have had previous miscarriages are at a higher risk of experiencing another one.
The Power of Nutrition: How Diet Can Help
While many factors contributing to miscarriage are beyond our control, nutrition is a modifiable aspect that can significantly impact pregnancy health. A healthy, balanced diet before and during pregnancy provides essential nutrients for both the mother and the developing baby. Research suggests that specific foods, food groups, and nutrients may be particularly beneficial in reducing the risk of miscarriage.
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A recently published report reviewed 20 different studies involving 65,000 women and what they ate for three months prior to and after conception.
Key Nutrients and Foods for Miscarriage Prevention
- Folate and Folic Acid: Folate helps your baby's neural tube grow. Taking folic acid supplements helps protect your baby from developing spina bifida and other conditions that affect their spine and neural tube (NTDS). Folate is crucial for preventing neural tube defects, and research suggests it may also play a role in reducing the risk of miscarriage. By both increasing folate intake from food and by increasing the amount of folate supplemented, in one study there was an associated reduced risk of miscarriage by 10% and 20% respectively. Food sources of folate include legumes (beans, peanuts, chickpeas, peas, soybeans) and dark, leafy greens (spinach, broccoli, kale, turnip greens).
- Vitamin D: There is not enough research yet to show that taking vitamin D supplements will help prevent miscarriage, but it may help. Recent research has shown an association between optimal vitamin D levels and a reduced miscarriage risk. What is really important to know is that vitamin D deficiency is typically diagnosed when you have a level of less than 50nmol/L on your blood test. However, the optimal level for reducing the risk of pregnancy loss appears to be having a vitamin D level 75nmol/L or higher, based on the recent research. The primary source of vitamin D is sunlight, but it can also be found in eggs and oily fish.
- Vitamin B3 (Niacin): Vitamin B3 deficiency has been linked to a higher incidence of miscarriage and foetal abnormalities, and supplementation may be protective. An adequate intake of niacin may help with healthy brain development in your baby and reduce the risk of birth defects and pregnancy loss. Niacin-containing foods include meat, fish and poultry as well as eggs, milk, cereals, wholegrains and nuts.
- Choline: Recent studies have highlighted the importance of adequate choline intake during pregnancy. As an essential nutrient it plays a key role in metabolic and physiologic processes throughout our body. The requirement for choline increases in pregnancy to support rapid cell division, growth and myelination. Research suggests that increasing our choline intake may have beneficial impacts on pregnancy outcomes, including a reduced rate of neural tube defects, improved function of the placenta and improved cognitive processes during infancy and early childhood. Food sources of choline include eggs, beef, chicken and fish as well as nuts, legumes, cruciferous vegetables (e.g.
- Dairy Products: Consumption of dairy products during pregnancy (like milk and cheese) have shown a protective association against miscarriage. This is most likely due to the increased intake of essential vitamins (such as vitamin A and B group vitamins) and calcium that are found in healthy amounts in dairy products. Just make sure that the dairy products you choose have been pasteurised to ensure they are safe for consumption during pregnancy. A guideline amount is 2 to 3 serves per day. Examples of one serve are one cup (250mL) of milk, 2 thin slices (40g) of cheese or about 3/4 cup of yoghurt.
- Fish: Consumption of fish was also associated with a lower risk of miscarriage. Fish is a great source of lean protein and essential nutrients for pregnancy including iodine, zinc and selenium. Oily fish such as salmon and sardines are also high in omega-3 fatty acids, which are essential for your baby’s brain development and may also help to reduce the risk of pregnancy complications including preterm birth and low infant birth weight. You can limit this risk by consuming only low mercury fish and varying your protein intake - have fish two to three times a week.
- Eggs: Eggs are an excellent food choice during preconception and pregnancy as they are nutrient dense and are a great source of protein, choline, B vitamins, vitamins A and D as well as folate and iron. Regularly consuming eggs has also been associated with a reduced risk of pregnancy loss. While pregnant, eggs should only be consumed if they have been fully cooked, or the internal temperature has reached 71 degrees celsius (set white, firm yolk).
- Fruits and Vegetables: Increased fruit and vegetable consumption is associated with a reduced risk of pregnancy loss. In one study, females who consumed more than 14 servings of green vegetables per week had reduced risk of miscarriage. Females consuming more than 14 serves of fruit per week had similar results. Another study indicated that eating fresh fruit and vegetables on most days or daily was associated with a halving in the risk of miscarriage.
- Water: You’ll need tons of water during pregnancy - even more than usual.
Foods and Drinks to Avoid During Pregnancy
Pregnancy demands heightened vigilance about what goes on your plate and in your cup.
- Alcohol: There is no safe amount of alcohol during pregnancy.
- High levels of caffeine: High caffeine intake (over 200 mg per day) can increase the risk of miscarriage and low birth weight. You and your partner may find it helpful to cut out caffeine or make sure you have less than 200mg a day.
- Raw Sprouts: Raw sprouts like alfalfa, mung beans, and clover can carry bacteria such as E.
- Certain Herbal Teas and Supplements: Some herbal teas (e.g., chamomile or ginseng) and herbal supplements may induce contractions or interact with medications.
- Artificial Sweeteners: Excessive consumption of artificial sweeteners like saccharin can have adverse effects.
- Raw Dough or Batter: Consuming raw dough made with eggs or flour increases the risk of Salmonella or E.
Additional Tips for a Healthy Pregnancy
- Maintain a healthy weight.
- Get some regular exercise every day. Aim for consistency over intensity.
- Keep stress in check.
- Practice Safe Food Handling: Washing your hands regularly, especially when you’ve been exposed to germs. Cook your meat completely. You need to steer clear of raw meat, hot dogs, lunch meat, and deli meats. Heat your food until it’s completely done and the juices run clear. Warm processed meats in the microwave or on the stovetop until they’re steaming hot.
- Prenatal Care: Regular, ongoing prenatal care is your best defense against a chance of miscarriage. It’s very important to go to all your antenatal appointments and any other medical appointments you are offered during pregnancy. If you don’t want to go to your appointments because you're worried about having blood tests, tell the midwife about your fears. They can help support you.
- Medication Review: During your first prenatal appointment, it’s important to discuss your current medications with your doctor. Some medications may be perfectly fine when you’re not pregnant but can cause severe harm to your baby. Some medications are okay to take during certain trimesters but more dangerous during others.
Coping with Anxiety and Focusing on the Positive
Pregnancy after loss often comes with a new set of emotions as you simultaneously process the joy and the anxiety of what’s happening. Building a strong and protective preconception nutrition plan can help you manage this process.
Pregnancy is a bit of an emotional roller coaster. On top of that, your body is changing, so you may feel nauseated most of the time, and you’re never quite sure if a symptom is a normal sign of pregnancy or something more worrisome. Unfortunately, pregnant women often feel a loss of control during pregnancy.
To ensure optimum health for your baby and relieve your own anxiety about a chance of miscarriage, try to focus on your personal health throughout pregnancy. Stay hydrated, eat a balanced diet, avoid harmful substances, and limit medications. Most importantly, however, try to focus on the positive aspects of pregnancy. There’s so much to look forward to in the days ahead. The odds are high that you’ll make it through pregnancy with no serious complications.
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