Listeria and Other Infections

Infection by the bacterium Listeria monocytogenes causes mild flulike symptoms, such as fever, headache, and vomiting, about 7 to 30 days after exposure. However, pregnant women, newborn infants, and people with depressed immune function may suffer more severe symptoms, including spontaneous abortion and serious blood infections. In these high-risk people, 25% of infections may be fatal.

Because unpasteurized milk, soft cheeses made from raw milk (brie, camembert, feta, and blue cheeses), and raw cabbage can be sources of Listeria organisms, it is especially important that pregnant women and other people at high risk avoid these products. Experts advise consuming only pasteurized milk products and cooking meat, poultry, and seafood thoroughly to kill this and other foodborne organisms. It is unsafe in pregnancy to eat any raw meats or other raw animal products.

Toxoplasmosis is another infection that causes birth defects. Pregnant women should limit exposure to the organism that causes toxoplasmosis by avoiding contact with cat feces (have someone else clean the cat's litter box), and avoiding contact with kittens, bird feces, and garden soil, and by not eating raw or undercooked meat.

Many of the risk factors described in this Nutrition Insight are avoidable. The goal of a reduction in maternal and infant deaths requires that more attention be paid to these problems.

Prenatal Care and Counseling

Education, an adequate diet, and early and consistent prenatal medical care maximize the chances of producing a healthy baby and avoiding the risks just covered, such as X-ray exposure, smoking, vitamin A supplements, medicines, illegal drugs, and alco­hol use. If diabetes or hypertension is present or developing, it must be carefully con­trolled to minimize complications in the pregnancy.

Again, women should receive these examinations and counseling strategies before becoming pregnant. Certainly, they should begin early in pregnancy. Many potential problems that develop associated with pregnancy can be diagnosed and quickly treated medically.

Physiological Changes That Can Cause Discomfort in Pregnancy

During pregnancy, the fetus's needs for oxygen, nutrients, and excretion increase the burden on the mother's lungs, heart, and kidneys. Although a mother's digestive and metabolic systems work very efficiently, some discomfort accompanies the changes her body undergoes to accommodate the fetus.

Heartburn, Constipation, and Hemorrhoids

Hormones produced by the placenta relax muscles in both the uterus and the intesti­nal tract. This often causes heartburn as stomach acid slips up into the esophagus. When this occurs, the woman should avoid lying down right after eating, eat less fat so that foods pass more quickly from the stomach into the small intestine, and avoid spicy foods she can't tolerate. She should also consume liquids between meals to decrease stomach volume and pressure. Women with more severe cases may need antacids or related medications.

Constipation often results as the intestinal muscles relax during pregnancy. It is es­pecially likely to develop late in pregnancy, as the fetus competes with the GI tract for space in the abdominal cavity. To offset these discomforts, a woman should perform regular exercise and consume more fluid, dietary fiber, and dried fruits, such as prunes (dried plums). These practices can help prevent constipation and a problem that fre­quently accompanies it, hemorrhoids. Straining during elimination can lead to hem­orrhoids, which are already more likely to occur during pregnancy because of other body changes. A reevaluation of the need and dose of iron supplementation also should be considered, as this practice is linked to constipation (especially intakes greater than 120 milligrams per day).