Stage of development during pregnancy.At this stage of development during your pregnancy you have to know about some of the things that you have to avoid. It's never too early to start thinking about how your activities and actions can affect your growing baby. Many substances you normally use may have adverse effects on the baby you carry. These substances include drugs, tobacco, alcohol and caffeine. Below is a discussion on cigarette smoking and alcohol use. (See pages 60 and 62 for information on drug abuse.) Any of these activities can harm a developing baby.
Cigarette Smoking
Smoking cigarettes has harmful effects on a pregnancy. A pregnant woman who smokes 20 cigarettes a day (one pack) inhales tobacco smoke more than 11,000 times during an average pregnancy!
Tobacco smoke contains many harmful substances, such as nicotine, carbon monoxide, hydrogen cyanide, tars, resins and some cancer-causing agents (carcinogens). These substances may be responsible singly or together for damaging your developing baby.
Scientific evidence has shown smoking during pregnancy increases the risk of fetal death or fetal damage. Smoking interferes with a woman's absorption of vitamins B and C and folic acid. Lack of folic acid can result in neural-tube defects and increases the risk of pregnancy-related complications in a mother-to-be.
For more than 20 years, we have known infants born to mothers who smoke weigh less by about 7 ounces (200g). That is why cigarette packages carry a warning to women about smoking during pregnancy. Decreased birthweight is directly related to the number of cigarettes the expectant mother smoked. These effects don't appear in her other babies if the mother doesn't smoke with other pregnancies. There is a direct relationship between smoking and impaired fetal growth.
Children born to mothers who smoked during pregnancy have been observed to have lower IQ scores and increased incidence of reading disorders compared with children of nonsmokers. The incidence of minimal-brain-dysfunction syndrome (hyperactivity) has also been reported to be higher among children of mothers who smoked during pregnancy.
Cigarette smoking during pregnancy increases the risk of miscarriage and fetal death or death of a baby soon after birth. The risk is also directly related to the number of cigarettes the pregnant woman smokes. The risk may increase as much as 35% in a woman who smokes more than one pack of cigarettes a day.
Smoking also increases the incidence of serious complications in a mother-to-be. An example of this is placental abruption, discussed in detail in Week 33. The risk of developing placental abruption increases by almost 25% in moderate smokers and more than 65% in heavy smokers.
Placenta previa (discussed in Week 35) also occurs more frequently among smokers. The rate of occurrence increases by 25% in moderate smokers and 90% in heavy smokers.
Known or suspected harmful effects to general health from smoking are numerous and include increased risk of many illnesses:
• pulmonary diseases, such as chronic bronchitis, emphysema and cancer
• cardiovascular diseases, including ischemic heart disease, peripheral vascular disease or arteriosclerosis
• bladder cancer
• peptic-ulcer disease
In addition, smokers have a mortality rate 30 to 80% higher than nonsmokers.
What can you do? The answer sounds simple but isn't quit smoking (see the box on page 39). In more realistic terms, a woman who smokes during pregnancy will benefit from reducing or stopping cigarette use before or during pregnancy and so will her developing baby. Some studies indicate that a nonsmoker and her unborn baby exposed to secondary smoke (cigarette smoke in the environment) are exposed to nicotine and other harmful substances. Perhaps pregnancy can serve as good motivation for everyone in the family to stop smoking!
Alcohol Use
Alcohol use by a pregnant woman carries risk. Moderate drinking has been linked to an increased chance of miscarriage. Excessive alcohol consumption during pregnancy often results in fetal abnormalities. Chronic use of alcohol in pregnancy can lead to abnormal fetal development called fetal alcohol syndrome (FAS). FAS is characterized by growth retardation before and after birth, and defects in limbs, the heart and facial characteristics of children. Facial characteristics are recognizable the nose is upturned and short, the upper jawbone is flat and the eyes look "different." An FAS child may also have behavioral problems.
FAS children often have impaired speech, and their fine and gross motor functions are impaired. The perinatal (time before, during and immediately after birth) mortality rate is 15 to 20%.
Most studies indicate women would have to drink four to five drinks a day for FAS to occur. But mild abnormalities have been associated with two drinks a day (1 ounce of alcohol). These milder defects are the result of fetal alcohol exposure (FAE), a condition that can result from very little alcohol. This has led many researchers to conclude there is no safe level of alcohol consumption during pregnancy. For this reason, all alcoholic beverages in the United States carry warning labels similar to those on cigarette packages. The warning advises women to avoid alcohol during pregnancy because of the possibility of fetal problems, including fetal alcohol exposure and fetal alcohol syndrome.
Taking drugs with alcohol increases the chances of damage to a baby. Analgesics, antidepressants and anticonvulsants cause the most concern. Some researchers have suggested the father's heavy alcohol consumption before conception may also result in fetal alcohol syndrome. Alcohol intake by the father has been cited as one possible cause of intrauterine-growth retardation.
As a precaution, be very careful about over-the-counter cough and cold remedies you may use. Many contain alcohol some as much as 25%!
Some women want to know if they can drink socially. There is a great deal of disagreement about it because there is no known safe level of alcohol consumption during pregnancy. Why take chances? For the health and well-being of your developing baby, abstain from alcohol during pregnancy. Responsibility for preventing these problems rests squarely on your shoulders!
Your Nutrition.
If your weight is normal before pregnancy, you need to increase your caloric intake during pregnancy. During the first trimester (first 13 weeks), you should eat a total of about 2,200 calories a day.
During the second and third trimesters, you probably need an additional 300 calories each day.
Extra calories provide the energy your • body needs for you and your growing baby. Your baby uses the energy to create and to store protein, fat and carbohydrates. It needs energy for fetal body processes to function. The extra calories also support changes your body is going through. Your uterus increases in size and your blood volume increases by about 50%.
You can meet most of your nutritional needs by eating a well-balanced, varied diet. The quality of your calories is important, too. If a food grows in the ground or on a tree (meaning it's fresh), it's probably better for you than if it comes out of a box or can.
Be cautious about adding the extra 300 calories to your nutrition plan it doesn't mean doubling your portions. A medium apple and a cup of low-fat yogurt add up to 300 calories!
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