Threats In Pregnancy

We take a closer look at health issues, situations and substances that may impact your baby’s development and wellbeing

The key to a healthy pregnancy is eating a balanced diet, getting exercise and adequate sleep and educating yourself on those lifestyle habits and situations that could pose a risk to your baby. Some of these hazards may be more common than others, depending on your individual situation and the likelihood that you will come into contact with them. In some cases, a particular threat may be out of your control and your healthcare provider will work to provide the best outcome for you and your baby.

Health Threats

Health issues and complications may pose a risk to your health or your baby’s growth and development.

Baby’s Development

Genetic disorders – Hereditary conditions can be passed down through your genes or your partner’s genes to your baby. Examples of these include cystic fibrosis and sick-cell anaemia.

Chromosomal disorders – These can be inherited or happen per chance. Some occur during the development of the egg or sperm, or shortly after conception. Down Syndrome is the most common birth defect relating to chromosomal problems and caused when the baby has an extra copy of chromosome 21.

Birth defects – These may be detected during pregnancy or diagnosed at birth. Some may be mild or more severe, causing lifelong problems. Others are life threatening. Birth defects like cleft pallet or club foot may not pose a risk to your baby’s life but will require surgery or intervention after the birth. Birth defects may be the result of a genetic mutation (change in the genes), exposure to certain chemicals during development or are even classified as unknown.

What you can do:  If you are concerned about a genetic problem in either yours or your partner’s family, speak to your healthcare provider. First and second trimester screenings may be offered and include blood tests and an ultrasound exam. If you are unsure or concerned about genetic disorders, you can also consult a genetic counsellor. Mothers over 35 years of age will be offered a screening test for Down Syndrome as part of the second trimester screenings.

Maternal Health

Pre-existing health conditions – This includes hypertension (high blood pressure), diabetes mellitus, heart, lung or kidney diseases, polycystic ovary syndrome (PCOS), obesity, autoimmune disease (lupus, rheumatoid arthritis etc.) are carefully monitored in pregnancy. If yours is considered a high-risk pregnancy, you may require specialist care under a gynaecologist during your pregnancy.

Infection  – An infection caused by some viruses or bacteria may cause serious complications that can lead to miscarriage, preterm labour or birth defects. Some infections are dangerous for mom or baby, or both. In some cases, the medications needed to treat certain illnesses are contraindicated in pregnancy. Diseases that cause complications are chickenpox, toxoplasmosis (transmitted in the faeces of cats or raw/undercooked meat), rubella (German measles), influenza, listeriosis (listeria bacteria in processed meat products), malaria and others. If you have symptoms of illness, including flu-like symptoms, a high fever, fatigue, or other symptoms that concern you, contact your healthcare provider.

Pregnancy complications – These are pregnancy-specific complications that can pose a risk to you and your baby. This includes gestational diabetes mellitus (GDM), a type of diabetes that occurs only during pregnancy and preeclampsia, a condition characterised by high blood pressure and protein in the urine. Placenta previa is a condition where the placenta (the organ in the womb that supplies the baby with oxygen and nutrients) completely or partially covers the cervix. Vaginal bleeding in pregnancy is a common symptom of placenta previa and you may need to deliver your baby by C-section if you have this complication.

Sexually transmitted infections (STIs) – Contracting an STI during pregnancy increases the risk of miscarriage, uterine infection, preterm birth or stillbirth. Some STIs can also cause birth defects that may lead to long term health complications for the baby. You will be offered screenings for STIs, including HIV, at a prenatal check-up. Practise safe sex during pregnancy by using condoms to protect both yourself and your baby.

Lifestyle Threats

Everyday situations that could impact your baby’s health and development.

• An unhealthy diet. Gaining too little or too much weight can pose a risk to your baby’s development and may lead to complications.
• Not getting enough or the right nutrients. A balanced diet, with a daily prenatal multivitamin, is essential to ensure that your baby gets the nutrients they need for development. Not getting certain nutrients, for example, folic acid, has been linked to neural tube defects like spina bifida. As part of your maternity benefits, the Scheme will pay for a product prescribed by your healthcare provider from the Maternity formulary list, up to R165 per month.
• Unsafe foods. This includes unpasteurised dairy products, raw or undercooked meat and processed meat products that may harbour bacteria that can cause illness.
• Smoking, drinking alcohol and using illicit drugs. Research indicates that using, abusing or overusing tobacco products, marijuana (dagga), alcohol or illicit (street) drugs can have a serious impact on an unborn baby’s growth and development. Both smoking and alcohol usage in pregnancy are linked to miscarriage, stillbirth and premature birth (where baby is born before 37 weeks). No amount of these substances or the number of cigarettes smoked per day is considered safe.
• Using unsafe prescription or OTC medication. Never take any medication without first consulting your healthcare provider as some medications can be harmful to your baby.
• Taking part in a contact sport or high-impact exercise. Daily exercise is part of a healthy pregnancy and a good way to prepare your body for labour and delivery. However, high-impact exercises should be avoided as they can cause stress on the bones, joints and muscles. All contact sports or a sport where you may fall from a height should be avoided. Falls in the late second trimester or third trimester, especially a direct blow to your abdomen, can be harmful to you and your baby.

Environmental or Situational Threats

•  Your working environment. Working in a hazardous environment, strenuous work (including standing for long periods of time) or heavy lifting can pose a threat to your pregnancy. In terms of the law, your employer must offer you alternative employment to safeguard your health and your baby’s health while you are pregnant.
• Gender-based violence. If you are a victim of gender-based violence, reach out to your healthcare provider or a trusted friend, family member or community leader (midwife, pastor, social worker etc.). Women who are victims of violence in pregnancy are at greater risk for a premature birth and having a baby with a low birth weight. Violence in pregnancy can also lead to miscarriage, vaginal bleeding and physical injuries to mother and baby.
• It’s safe to fly up until 36 weeks (earlier with multiples) but you may need to supply a letter from your healthcare provider stating your due date. If yours is a high-risk pregnancy, your healthcare provider may advise you not to fly at any stage of your pregnancy.
• Having an x-ray. Your healthcare provider is best placed to consider the risks and the reasons why you need to have an x-ray in pregnancy. X-rays are safe with low levels of radiation that are unlikely to be harmful. If you need to have an x-ray during your pregnancy, let the technician know so that the proper precautions can be taken.

While threats are real and can be scary, try to avoid a situation where you become overly anxious or overwhelmed about them. If you are unsure about the safety of a particular activity, food, medication or situation, rather speak to your healthcare provider or call your midwife on the Maternity Programme before you go ahead.

Resources: https://kidshealth.org/; https://www.healthline.com/; https://www.babycentre.co.uk/; https://www.news-medical.net/; https://www.pregnancybirthbaby.org.au/; https://www.nhs.uk/; https://www.hopkinsmedicine.org/; https://www.webmd.com/; https://www.marchofdimes.org/; https://www.acog.org/; https://www.mayoclinic.org/; https://medlineplus.gov/; https://www.stanfordchildrens.org/