This is a guest article by Silvio Aladjem MD.
New Year resolutions come and go with each New Year. Statistics show that 88% of us do not follow through with them. Historically, making New Year resolutions date back to antiquity. At that time every New Year people made vows to the gods for what they wanted to achieve in the coming year, and asked for their support. I would venture to say that the level of accomplishments were probably not better than what statistics show today.
Many books and articles list a number of popular New Year Resolutions. I would like to comment on three resolutions that may impact pregnancy. My three choices are: I will lose weight, I will quit smoking, and I will quit drinking. My choice has a purpose. These three eternal resolutions, whether taken seriously or not, may impact the pregnancy and your baby.
Let us start with “I will lose some weight”. Sorry. Pregnancy is not the time to lose weight. Pregnancy is the time to gain weight. Your baby’s development depends on a constant flow of nutrients, vitamins, and other necessary essential elements. Restricting their intake, may adversely affect the baby’s wellbeing. I am sure you don’t want that.
The question is how much weight should you gain, in order to secure adequate supplies for the infant and at the same time not gain so much weight that may compromise the infant and, in the long term, your wellbeing and figure.
It used to be that 20 to 25 lbs was the magic figure that everybody seemed to agree upon. Like everything else, our knowledge improves and now these figures are being contested. Recent studies at the University of Maryland showed that in order to determine the ideal weight gain for any pregnant woman, one has to take into account her BMI, which stands for Body Mass Index (BMI). This is a number calculated from a person’s weight and height. It allows us to evaluate body fatness as well as categorize the individual in a weight category that may lead to health problems when abnormal. The categories determined by the BMI are: Normal, Overweight, Obese, or Underweight. Many argue that BMI is less than perfect. May be, but it is the best we have and, most importantly, it is objective.
According to guidelines published by the Institute of Medicine (IOM), underweight women should gain between 28 and 40 pounds during pregnancy, while normal weight women are expected to gain 25-35 pounds, overweight women 15-25 pounds, and obese women 11-20 pounds. If you are pregnant, your doctor should be able to calculate what weight is good for you.
So, your first New Year resolution, if you are or plan to be pregnant should be: I will gain the amount of weight which is best for my baby’s wellbeing.
The second resolution, I will quit smoking, has to be taken very seriously. When you smoke, the baby smokes. When you smoke, you have circulating in your body hazardous chemicals like nicotine, carbon monoxide and tar. Your blood oxygen decreases. As a result the baby receives less oxygen. A host of problems are associated with smoking in pregnancy: small babies, double the risk for stillbirths, placental problems like abruption (separation of the placenta before birth) and placenta previa (placenta implanting over the uterine cervix). Both of these placental abnormalities may be associated with heavy bleeding, which may threaten your life as well as that of the baby), Preterm births, small babies, high blood pressure and a core of other problems have also been associated with smoking in pregnancy. No matter how you look at smoking, there is no redeeming factor to justify it. I hope you can keep this promise. One last thing, second hand smoking is bad too.
Finally, I will quit drinking, is the third New Year Resolution that I will address. Nobody argues that heavy drinking can have devastating effects on the infant, a syndrome that we call: Fetal Alcohol Syndrome (FAS). The syndrome is a collection of malformations. The following may be part of the disorder: mental retardation, vision and hearing problems, joint deformities, facial deformities, small brain and head (microcephaly), heart defects, and many others.
The debate comes when the question is raised regarding an “occasional glass of wine”. It certainly depends on how occasional is “occasional”. There have been number of studies after studies, primarily in Europe, attempting to shed light on the “Occasional” glass of wine. There was a Dutch study, which made the ABC news in 2012, concluding that women who used alcohol during pregnancy, in “moderate” amounts, defined as one drink a day,( they did not state if wine was equal to bourbon) when compared with those that did not use alcohol at all during pregnancy, had infants without any apparent neurological problem. Thus, they concluded that it is ok to have a drink a day, but if you have more than 9 drinks a week, you may be in trouble – i.e. the baby may show neurological abnormalities. Of course, as usual, a disclaimer was made that “additional studies should be undertaken”. It is not clear where the 9 drinks a week came from, nor is it clear that if you had 10 drinks you are “out” or whether around 9 would be ok as well.
Both the Surgeon General of the United States and the British Department of Health recommendations are that no alcohol should be consumed at all during pregnancy. These positions are definitely safe. Such recommendations may change if and when new “solid” facts come to light, but if you want to be “absolutely certain” the recommendation is “No drinks in pregnancy”.
So, there we are. In the practice of medicine, we physicians can only make recommendations as to what is safe in pregnancy. Nature is never 100% in anything. If you decided to go against medical advice and have no problems, it is just a statistical occurrence. Someone else, somewhere, probably was not so lucky. Unfortunately, it could have been just as well the other way around
Have a Happy New Year!
SILVIO ALADJEM MD, an obstetrician/gynecologist and Maternal Fetal Medicine (high risk obstetrics) specialist, is Professor Emeritus in obstetrics and gynecology at Michigan State University, College of Human Medicine, in Lansing, MI. He is the author of “10,000 babies: my life in the delivery room” now available on Amazon, Barnes and Noble and other book stores. Dr. Aladjem published extensively in Scientific Medical Journals and wrote several textbooks in the specialty. He can be reached through his website, www.drsilvio.com.