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them\tat\thome\tfollowing\tgeneral\tfood\tsafety\tguidelines.\n•\t\nDo\tnot\teat\trefrigerated\tsmoked\tseafood\tunless\tit\tis\tin\ta\tcooked\tdish\t(165°\tF).\tThis\nincludes\tsmoked\tsalmon,\n\ttrout,\twhitefish,\tcod,\ttuna,\tand\tmackerel.\tThey\tare\toften\nlabeled\t“nova-style,”\t“lox,”\t“kippered,”\t“smoked,”\tor\t“jerky.”\tThey\tare\tfound\tin\tthe
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refrigerated\tsection\tor\tsold\tat\tthe\tdeli\tcounter.\tCanned\tor\tshelf-stable\tversions\tmay\tbe\neaten.\nAdapted\tfrom\tCox\tJT,\tPhelan\tST:\tFood\tsafety\tin\tpregnancy,\tpart\t1:\tputting\trisks\tinto\tperspective,\nContemporary\tOb/Gyn\n\t54:44,\t2009a;\tUnited\tStates\tDepartment\n\tof\tHealth\tand\tHuman\tServices\n(USDHHS):\t\nFood\tSafety\tfor\tPregnant\tWomen\n\t(website):
|
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] |
(USDHHS):\t\nFood\tSafety\tfor\tPregnant\tWomen\n\t(website):\nhttps://www.foodsafety.gov/risk/pregnant/index.html#_Food_Poisoning_During_1\n,\t2018.\nMercury\tand\tpolychlorinated\tbiphenyls\t(PCBs)\nMethylmercury\tcontamination\tis\tknown\tto\taffect\tfetal\tneural\tdevelopment\tdisproportionately.\tIt
|
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] |
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] |
are\tlarge\tand\tpredatory.\tAlthough\tadvisories\tare\tspecific\tto\tlocal\tconditions,\tthe\tU.S.\tEPA\tand\tFDA\ncurrently\trecommend\tthat\tall\twomen\tof\tchildbearing\tage\tavoid\tthe\tconsumption\tof\tthose\tfish\tthat\nsurpass\t1\tppm\tmethylmercury.\tThe\tmethylmercury\n\taccumulates\tin\tthe\tlean\ttissue,\tso\tcooking\nmethods\tdo\tnot\taffect\tthe\tmercury\tcontent\tof\tthe\tfish\t(see
|
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] |
methods\tdo\tnot\taffect\tthe\tmercury\tcontent\tof\tthe\tfish\t(see\t\nFocus\tOn:\n\tChildhood\tMethylmercury\nExposure\tand\tToxicity\tin\t\nChapter\t16\n).\nNot\teveryone\thas\tfound\tlong-term\tproblems\twith\tmethylmercury\tconsumption\t(\nVan\tWijngaarden\tet\nal,\t2013\n).\tResearch\tshows\tthat\tselenium\tmay\tmitigate\tthe\tharmful\teffects\tof\tmercury\tby\ta\tvariety\tof
|
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] |
potential\tmechanisms.\tHowever,\n\tthe\trole\tof\tselenium\tin\tmercury\tpoisoning\tis\tmultifaceted\tand\nbidirectional,\twith\tcomplex\tinteractions\tdepending\ton\tthe\tform\tof\tmercury,\tthe\tform\tof\tselenium,\tthe\norgan,\tand\tthe\tdose\t(\nSpiller,\t2018\n).\tThe\tselenium\tand\tmercury\tcontents\tof\tfish\tand\tshellfish\tare\tnow\nbeing\tcharacterized\tworldwide\t(
|
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] |
being\tcharacterized\tworldwide\t(\nBurger\tand\tGochfeld,\t2013\n).\tAlthough\tsome\thave\tpromoted\ta\nselenium:mercury\tratio\tas\ta\tbetter\tway\tto\tcharacterize\n\trisk,\tthat\tmay\tbe\tpremature.\tSelenium\nappears\tto\tprotect\tagainst\tmercury\ttoxicity\tonly\tup\tto\ta\tlimit,\tand\texcess\tselenium\talso\tcan\tbe\thighly\ntoxic.
|
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0.013935735449194908,
0.06695149093866348,
-0.021063409745693207,
-0.053362924605607986,
-0.026928042992949486,
0.04835677891969681,
0.033227406442165375,
0.04698259383440018,
-0.04846334829926491,
-0.007880674675107002,
0.09804393351078033,
0.029480407014489174,
0.1004069447517395,
0.02687087655067444
] |
toxic.\nFish\talso\tcan\tbe\ta\tsource\tof\tpolychlorinated\tbiphenyls\t(PCBs),\tand\tprenatal\texposure\thas\tbeen\nassociated\twith\tchild\tneurologic\tdeficits\t(\nCox\tand\tPhelan,\t2009b\n).\tAlthough\tno\tlonger\tproduced,\nPCBs\tstill\tremain\tin\tthe\twater\tsystems.\tAlthough\tPCBs\tcan\n\tbe\tabsorbed\tthrough\tthe\tskin\tand\tlungs,
|
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0.06610048562288284,
0.13352875411510468,
0.036644645035266876
] |
be\tabsorbed\tthrough\tthe\tskin\tand\tlungs,\nthey\tprimarily\tenter\tthe\tbody\tfrom\tingestion\tof\tcontaminated\tfatty\tfish.\tFarmed\tand\twild\tocean\tfish\ncan\tcontain\tPCBs,\tbut\tfresh\twater\tfish\tfrom\tthe\tGreat\tLakes\tare\toften\tof\tmore\tconcern.\tPCBs\treadily\npass\tthrough\tthe\tplacenta\tand\tbreastmilk.\tPregnant\tand\tnursing\twomen\tshould\tavoid\teating\tfish
|
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] |
from\twater\tknown\tto\tbe\thighly\tcontaminated\twith\tPCBs.\tFish\tfrom\tother\n\tareas\tshould\tbe\tcooked\tto\nminimize\tthe\tingestion\tof\tthe\tfat\tand\tthe\tskin\tshould\tnot\tbe\teaten.\nRegarding\twild\tversus\tfarmed\tsalmon,\tthere\tis\tcontroversy.\tFarmed\tAtlantic\tsalmon\tis\thigher\tin
|
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] |
contaminants\t(PCBs,\tdioxins,\tpolybrominated\tdiphenyl\tethers\tor\tPBDEs,\tand\tsome\tpesticides)\tthan\nwild\tPacific\tsalmon,\tbut\tit\talso\tcontains\thigher\tlevels\tof\tomega-3s\tthan\twild\tPacific\tsalmon.\tAlthough\nno\tdata\n\tare\tspecific\tto\tpregnancy,\tresearchers\tconclude\tthat\tthe\tbenefit\t(lives\tsaved\tfrom\tcoronary
|
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] |
disease)\tfrom\tNorth\tand\tSouth\tAmerican\tfarmed\tsources\toutweighs\tthe\trisk\t(lives\tlost\tto\tcancer)\tand\nis\ton\tpar\twith\tthe\twild\tsources\t(\nCox\tand\tPhelan,\t2009b\n).\nThe\tfederal\tguidelines\tregarding\tthe\tconsumption\tof\tcommercially\tavailable\tfish\thave\tincreased\nthe\tnumber\tof\tfishes\tthat\tshould\tbe\tavoided\t(see\t\nChapter\t16
|
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] |
the\tnumber\tof\tfishes\tthat\tshould\tbe\tavoided\t(see\t\nChapter\t16\n).\tLocal\tfresh\twaters\tand\ttherefore\tfish\nmay\talso\tbe\tcontaminated.\tQuestions\tregarding\tmethylmercury,\tPCBs,\tand\tother\tcontaminants\nshould\tbe\tdirected\tto\tstate\tnatural\tresource\tdepartments.\tIn\taddition,\tmany\tfish\thave\tdifferent\tlocal
|
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] |
names\tand\tboth\tavailability\tand\tacceptability\tvary\twidely,\tso\tthe\tguidance\tmany\tneed\tto\tbe\tadapted\nto\tlocal\tconditions.\nMost\tfish\tand\tseafood\tare\tlow\tin\tmethylmercury,\n\tand\ta\tfew\tare\tparticularly\thigh\tin\tDHA\t(see\t\nFocus\nOn:\n\tOmega-3\tFatty\tAcids\tin\tPregnancy\tand\tLactation\n),\tso\tconsumption\tshould\tbe\tpromoted.\tFish
|
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] |
),\tso\tconsumption\tshould\tbe\tpromoted.\tFish\nmay\tcarry\tpathogens\tas\twell\tand\tall\tfish\tand\tseafood\tshould\tbe\twell\tcooked\t(\nBox\t14.7\n).
|
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-0.028796983882784843,
-0.04789191484451294,
0.07451131194829941,
-0.011459093540906906,
-0.10484874248504639,
0.029325449839234352,
0.07659555226564407,
0.008426519110798836,
0.015536503866314888,
-0.04682708904147148,
0.03483372554183006,
0.030997905880212784,
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0.11441157013177872,
0.06035349518060684,
-0.03523779660463333
] |
BOX\t14.7\nFish\tSafety\tGuidelines\n•\t\nDo\tnot\teat\tshark,\ttilefish\tfrom\tthe\tGulf\tof\tMexico\t(also\tcalled\tgolden\tor\twhite\tsnapper,\ngolden\tbass),\tking\tmackerel,\tmarlin,\n\torange\troughy,\tbigeye\ttuna,\tor\tswordfish.\n•\t\nAlbacore\t(“white”)\tcanned\ttuna\tshould\tbe\tlimited\tto\t4\toz/week.\tSee\t\nChapter\t16\n\tfor\tother\tfish\nthat\tshould\talso\tbe\tlimited.\n•
|
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0.0005203418550081551
] |
Chapter\t16\n\tfor\tother\tfish\nthat\tshould\talso\tbe\tlimited.\n•\t\nOther\tcooked\tfish\tand\tseafood\tmay\tbe\teaten,\tup\tto\t12\toz/week.\tSee\t\nFocus\tOn:\n\tOmega-3\nFatty\tAcids\tin\tPregnancy\tand\tLactation\n\tfor\trecommended\tchoices.\n•\t\nAvoid\trefrigerated\tseafood\tproducts\tunless\tcooked\tbefore\teating\t(165°\tF).\n•
|
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] |
•\t\nAvoid\traw\tor\tundercooked\tfish\tand\tseafood,\tincluding\tsushi\tand\tshellfish.\tAll\tfish\tand\nshellfish\tshould\tbe\tcooked\tto\t145°\tF.\n•\t\nObserve\tlocal\tadvisories\tregarding\tmercury\tand\tother\tcontaminants.\tFor\taccess\tto\tyour\nstate’s\tor\tterritory’s\tadvisories,\tsee:\t\nhttps://fishadvisoryonline.epa.gov/general.aspx\n.
|
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] |
https://fishadvisoryonline.epa.gov/general.aspx\n.\nAdapted\tfrom\tCox\tJT,\tPhelan\tST:\tFood\tsafety\tin\tpregnancy,\tpart\t2:\twhat\tcan\tI\teat,\tdoctor?\t\nContemporary\nOb/Gyn\n\t54:24,\t2009b;\tUnited\tStates\tDepartment\tof\tHealth\tand\tHuman\tServices\t(USDHHS):\tFood\tSafety\nfor\tPregnant\tWomen\t(website):
|
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] |
for\tPregnant\tWomen\t(website):\nhttps://www.foodsafety.gov/risk/pregnant/index.html#_Food_Poisoning_During_1\n,\t2018;\tFood\tand\tDrug\nAdministration\t(FDA):\tAdvice\tabout\tEating\tFish:\t\nWhat\tPregnant\tWomen\t&\tParents\tShould\tKnow\n,\nNovember\t2017.\t\nhttps://www.fda.gov/Food/ResourcesForYou/Consumers/ucm393070.htm\n.\nOther\tfoodborne\tpathogens\tand\tprobiotics
|
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] |
.\nOther\tfoodborne\tpathogens\tand\tprobiotics\nBrucella\n\tspp.,\t\nSalmonella\n\tspp.,\tand\t\nCampylobacter\tjejuni\n\tare\talso\tof\tparticular\tconcern\tfor\tpregnant\nwomen\t(\nProcter\tand\tCampbell,\t2014\n).\tPrompt\tdiagnosis\tof\tbrucellosis\tand\tmaternal\tantibiotic\ntreatment\tcan\tsave\tthe\tlife\tof\tthe\tfetus.\tTransmission\tof\t\nBrucella\n\tspp.\tthrough\tbreastmilk\talso\thas
|
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] |
Brucella\n\tspp.\tthrough\tbreastmilk\talso\thas\nbeen\treported.\tCases\tof\tfetal\tsepsis\tand\tmultiorgan\tfailure,\n\tleading\tto\tdeath,\thave\tbeen\treported\nwith\tnontyphoidal\t\nSalmonella\n.\t\nSalmonella\ttyphi\n,\tthe\tbacteria\tthat\tcause\ttyphoid\tfever,\tand\nCampylobacter\tjejuni\n\tcan\tcross\tthe\tplacenta\tand\tinfect\tthe\tfetus,\tcausing\tmiscarriage,\tstillbirth,\tor
|
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] |
preterm\tlabor\t(\nDean\tand\tKendall,\t2012\n).\tIn\taddition,\tother\tfood\tcontaminants,\tincluding\t\nE.\tcoli\n,\tcan\naffect\tanyone,\tincluding\tpregnant\twomen.\tIf\texposed,\twomen\tshould\n\tbe\ttreated\tcarefully,\tavoiding\ndehydration.\tTo\tlimit\texposure,\tfood\trecalls\tshould\tbe\tobserved\tand\tcareful\tfood\tchoices\tshould\tbe\nmade.\tFederal\tguidance\tis\tavailable\t(see
|
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] |
made.\tFederal\tguidance\tis\tavailable\t(see\t\nChapter\t8\n).\nFor\ta\tdiscussion\tof\tthe\tissues\tregarding\tthe\tmicrobiome,\tsee\t\nClinical\tInsight:\n\tThe\tMicrobiome\nDuring\tPregnancy\tand\tLactation\n.\nCLINICAL\tINSIGHT\nThe\tMicrobiome\tDuring\tPregnancy\tand\tLactation\nThe\timportance\tof\n\tthe\tmicrobiome\tis\tnow\tmore\tappreciated,\tincluding\tduring\tpregnancy.\tWhile\tit
|
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] |
is\tnow\tgenerally\tthought\tthat\tthe\tpresence\tof\tbacteria\tis\tnot\tnecessarily\ta\tpathogenic\tcondition,\nthere\tis\tnot\tyet\tcomplete\tconsensus\ton\tthat\tpoint\t(\nManuck,\t2017\n;\t\nZhou\tand\tXiao,\t2018\n).\nThe\tmicrobiome\tof\tboth\tmales\tand\tfemales\tappears\tto\tplay\ta\trole\tin\tconception,\tincluding\tthe\nseminal\tfluid\tmicrobiome\t(\nYounes\tet\tal,\t2018
|
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] |
seminal\tfluid\tmicrobiome\t(\nYounes\tet\tal,\t2018\n).\tThe\tvaginal\tmicrobiome\tis\tknown\tto\tbe\timportant\nin\treproduction\tand\tappears\tto\taffect\tassisted\treproductive\ttechnology\t(ART)\tresults,\tbut\nresearch\tis\tstill\tpreliminary\t(\nGarcía-Velasco\tet\tal,\t2017\n).\tIt\tvaries\tover\ttime\tand\tbetween\twomen,
|
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] |
García-Velasco\tet\tal,\t2017\n).\tIt\tvaries\tover\ttime\tand\tbetween\twomen,\nbut\twhether,\tand\thow,\tthe\tdiet\taffects\tit\tis\tstill\tunknown.\tThe\tvaginal\tmicrobiome\tcolonizes\tthe\nnewborn\tduring\tdelivery,\tpotentially\taffecting\timmune\tfunction\n\tand\tneurodevelopment.\nIt\tis\tnow\tknown\tthat\tthe\tplacenta,\tamniotic\tfluid,\tand\tfetus\tare\tnot\tsterile\tand\tthat\tmicrobes
|
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] |
move\tfrom\tthe\tmaternal\tto\tthe\tfetal\tenvironment.\tHow\tthat\ttransfer\toccurs\tis\tnot\tcompletely\nclear\tbut\tis\thypothesized\tto\tbe\tthrough\tthe\tblood\t(\nPrince\tet\tal,\t2015\n),\tpossibly\tthrough\tincreased\npermeability\tof\tgingival\tvascular\tbed\tin\tgingivitis\t(\nYounes\tet\tal,\t2018\n).\tAlso\tunclear\n\tis\twhether\tthe\ntransfer\tcan\talso\tgo\tfrom\tthe\tfetus\tto\tthe\tmother\t(
|
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] |
is\twhether\tthe\ntransfer\tcan\talso\tgo\tfrom\tthe\tfetus\tto\tthe\tmother\t(\nPelzer\tet\tal,\t2017\n).\tThe\tmicrobiome\tof\tthe\nplacenta\tappears\tto\tbe\tunique,\tis\testablished\tearly,\tand\tis\tmore\tsimilar\tto\tthe\tmaternal\toral\tcavity\nthan\tto\ther\tgut,\tvaginal,\tor\tskin\tmicrobiome\t(\nPrince\tet\tal,\t2015\n).\tHistorically,\tthe\tconcern\thas
|
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] |
Prince\tet\tal,\t2015\n).\tHistorically,\tthe\tconcern\thas\nbeen\tthat\ttransfer\tof\tbacteria\tto\tamniotic\tfluid\tcould\tcause\tinflammation\tand\ttherefore\tpreterm\ndelivery.\tParticular\tconcern\tis\traised\tfor\tthose\twomen\twith\timmune\tsuppression\tor\tdysfunction,\nas\twell\tas\tthose\twith\tabnormalities\tin\tthe\tgastrointestinal\tmucosal\tbarrier.\tHowever,\tassuming
|
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the\tpresence\tof\tbacteria\tis\ta\tnormal\tphenomenon,\tquestions\tare\tnow\tbeing\tinvestigated\nregarding\thow\tthese\tbacteria\tvary,\twhat\timpact\tthey\thave,\tand\thow\tthey\tcan\tbe\tmodified\tto\thelp\nmaternal\tand\toffspring\n\thealth.\nIt\tis\tnow\tknown\tthat\tthe\tmicrobiome\tvaries\tbetween\twomen.\tIt\tgets\tless\tdiverse\tover\tthe\tcourse
|
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] |
of\tpregnancy\tand\tthe\tmicrobiome\tamong\twomen\twith\tgestational\tdiabetes\tmellitus\t(GDM)\tis\teven\nless\tdiverse\t(\nWickens\tet\tal,\t2017\n).\tThe\tconsequences\tof\tthe\tvariability\tare\tnot\tyet\tclear\tbut\tit\tis\nknown\tthat\tthe\tmicrobiome\tmidpregnancy\tdiffers\tamong\twomen\twho\tgo\ton\tto\tdeliver\tpreterm\n(\nManuck,\t2017\n)\tand\tit\tis\tspeculated\tthat\t\nLactobacillus
|
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] |
(\nManuck,\t2017\n)\tand\tit\tis\tspeculated\tthat\t\nLactobacillus\n\tmay\tprovide\tan\tantibacterial\tdefense\tover\nthe\tintraamniotic\tinfections\tassociated\twith\tpreterm\tbirth.\tThe\tmicrobiome\tmay\taffect\tperinatal\ndepression\tand\tanxiety\t(\nRackers\tet\tal,\t2018\n).\tThe\tdietary\tcomponents\taffecting\tmood,\tanxiety,
|
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).\tThe\tdietary\tcomponents\taffecting\tmood,\tanxiety,\nand\tstress\tresponse\tare\tnot\tcompletely\tclear\tbut\tit\tappears\ta\thigh\tfat\tdiet\taffects\tthe\tmicrobiome\ncomposition.\tIn\tmaternal\n\tobesity,\tan\taltered\tmicrobiome\tis\tassociated\twith\taltered\tshort-chain\nfatty\tacid\tproduction\tand\tgene\texpression,\tas\twell\tas\tpoor\tglucose\tcontrol,\tbut\twhether
|
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] |
interventions\tcan\thelp\trestrain\tweight\tgain,\treduce\tGDM\tfrequency,\tor\timprove\tinsulin\tsensitivity\nis\tunclear\t(\nZhou\tand\tXiao,\t2018\n).\tThere\tis\tno\tconsistent\tevidence\tthat\tinterventions\taffect\npreterm\tbirth\trisk\tor\tother\tinfant\tor\tmaternal\toutcomes,\n\tincluding\tSGA,\tLGA,\tor\tpremature\nrupture\tof\tmembranes\t(PROM)\t(\nJarde\tet\tal,\t2018
|
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rupture\tof\tmembranes\t(PROM)\t(\nJarde\tet\tal,\t2018\n).\tThere\tis\tsome\tevidence\tthat\tmaternal\nsupplementation\twith\tparticular\tstrains\tand\tdoses\tmay\tbe\thelpful\tin\tcontrolling\tgestational\nweight\tgain,\tfrequency\tof\tGDM,\tglycemic\tcontrol,\tmodulating\tinflammatory\tmarkers,\tand
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] |
reducing\tthe\trisk\tof\tpreeclampsia,\tas\twell\tas\tpreventing\tthe\tdevelopment\tof\tairway\tinflammation\nin\n\toffspring\t(in\tmice)\t(\nRodríguez-González\tet\tal,\t2018\n).\tAlso\tbeing\tinvestigated\tare\tthe\teffects\tof\nthe\tmicrobiome\ton\tthe\tfetus’\tdeveloping\timmune\tsystem\tand\tmetabolic\tfunctioning.\tHowever,\tin
|
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] |
the\tcase\tof\tatopic\tdisorders,\tit\tis\tnot\tclear\tif\tmaternal\tsupplementation\tduring\tpregnancy\tonly,\nwithout\tlactation\tor\tinfant\tsupplementation,\twill\tlower\tthe\trisk\tof\tinfant\teczema\t(\nWickens\tet\tal,\n2018\n;\t\nGarcia-Larsen\tet\tal,\t2018\n).\tIt\tis\tthought\tthat\tthe\tmicrobial\tcolonization\tof\tthe\tuterus,
|
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] |
).\tIt\tis\tthought\tthat\tthe\tmicrobial\tcolonization\tof\tthe\tuterus,\nplacenta,\tand\tamniotic\tfluid\tmay\tprime\tthe\tfetus\tto\tbecome\ttolerant\tto\tbacteria\tafter\tbirth\tand\ntherefore\taffect\tthe\tinfant\tmicrobiome\tand\tlong-term\thealth\t(\nYounes\tet\tal,\t2018\n).\nImproving\tmaternal\tdysbiosis\tmay\thelp\tinfant\thealth\tand\tprobiotics\tappear\tto\tbe\tsafe\twhen
|
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] |
used\tby\thealthy\tpeople.\tAttempts\tto\tmodify\tthe\tmaternal\tmicrobiome\n\tthrough\tthe\tuse\tof\nprebiotics\tand\tprobiotics\tare\tbeing\tinvestigated\tfor\tpotential\tbenefit\tduring\tpregnancy.\tHowever,\nthere\tis\tno\tevidence\tyet\tof\ta\tdirect\tbeneficial\teffect\tof\tprobiotics\ton\treproductive\thealth\toutcomes\n(\nGarcía-Velasco\tet\tal,\t2017
|
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] |
(\nGarcía-Velasco\tet\tal,\t2017\n).\tThe\tresults\tof\tinterventions\tare\toften\tinconsistent\tand,\talthough\nmost\tstudies\thave\tbeen\tdone\ton\twomen\twith\tnormal\tweight,\tit\tis\tunclear\tabout\tthe\timpact\n\tof\nprepregnant\tbody\tmass\tindex\t(BMI)\ton\tthe\tmicrobiome\tor\tthe\tability\tto\tchange\tit.\tThe\toptimal\ncombination\tof\tbacteria\t(most\toften\ttested\tare\t\nLactobacillus
|
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combination\tof\tbacteria\t(most\toften\ttested\tare\t\nLactobacillus\n\tspp.\tand/or\t\nBifidobacterium\n\tspp.),\nstrains,\tdosing,\ttiming\tand\tduration\tof\texposure,\tand\troutes\tof\tadministration,\tas\twell\tas\tthe\tage,\nbaseline\tnutritional\tstatus\tof\tthe\tmother,\tand\tthe\tinteraction\twith\tstress\tare\tall\tcritical\tand\tnot\tyet
|
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] |
clear,\tnor\tis\tthe\trelative\timpact\tof\tprobiotic\tsupplements\tcompared\twith\tthe\tconsumption\tof\nfermented\tfoods.\tHowever,\tthere\tis\tevidence\tthat\tthe\tuse\tof\tfermented\tmilk\tproducts\tis\tassociated\nwith\tup\tto\ta\t40%\treduction\tin\tthe\trisk\tof\tsevere\tpreeclampsia,\tdepending\ton\tthe\tdose\t(\nGriffin,\n2015\n),\tbut\teven\tjust\t30\tmL/day\tappears\thelpful\t(
|
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] |
Griffin,\n2015\n),\tbut\teven\tjust\t30\tmL/day\tappears\thelpful\t(\nBerti\tet\tal,\t2017\n).\tWhether\tthe\tbacteria\tmust\tbe\nwhole\tor\tliving\n\tis\talso\tunclear\tbut\tthere\tis\tevidence\tof\teffective\thost\tpriming,\teven\tif\tthe\tbacteria\nare\tdead,\tat\tleast\tin\tmurine\tstudies\t(\nPelzer\tet\tal,\t2017\n).\tIn\taddition,\tfor\tmany\tcommercial
|
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] |
Pelzer\tet\tal,\t2017\n).\tIn\taddition,\tfor\tmany\tcommercial\nproducts,\tthere\tappears\tto\tbe\ta\tlack\tof\tcorrelation\tbetween\tthe\tlabel\tand\tthe\tactual\tcontents\tof\nthe\tsupplements\t(\nJarde\tet\tal,\t2018\n)\tand,\twhile\tcontamination\twith\tpathogens\tis\tuncommon,\tit\thas\nbeen\treported\t(\nSohn\tand\tUnderwood,\t2017\n).\tMany\ttrials\tare\tunderway\tand\tthe\tclinical\tand
|
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] |
).\tMany\ttrials\tare\tunderway\tand\tthe\tclinical\tand\napplication\tguidelines\tare\tstill\tin\tdevelopment.\nDuring\tlactation,\tthe\tmilk\tmicrobiome\tmay\tcontribute\tto\tshort-\tand\tlong-term\tinfant\thealth\tand\nalso\tto\tmammary\thealth.\tMammary\tdysbiosis\toften\tleads\tto\tacute,\tsubacute,\tor\tsubclinical
|
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mastitis.\tThis\tcondition\tmay\tbe\tresistant\tto\tantibiotics\tand\tcould\tlead\tto\tundesired\tearly\tweaning.\nNew\tresearch\tproviding\n\tselected\tlactobacilli\tstrains\tisolated\tfrom\tbreastmilk\tshow\tpotential\tin\ntreating\tthis\tpainful\tcondition\tso\tthat\tthe\tcontinuation\tof\tsuccessful\tbreastfeeding\tis\tnot\njeopardized\t(\nFernández\tet\tal,\t2014\n).\nToxoplasma\tgondii
|
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0.07245223224163055,
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] |
jeopardized\t(\nFernández\tet\tal,\t2014\n).\nToxoplasma\tgondii\nToxoplasma\tgondii\n\tis\ta\tparasite\tthat\tmay\tcross\tthe\tplacenta,\tcausing\tmiscarriage\tor\tfetal\tdeath.\nSurvivors\thave\tchorioretinitis,\thearing\tloss,\tand\tlong-term\tneurologic\n\tand\tneurocognitive\tdeficits,\nbut\tcan\talso\thave\trashes,\thepatosplenomegaly,\tascites,\tfever,\tperiventricular\tcalcifications,
|
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] |
ventriculomegaly,\tand\tseizures\t(\nACOG,\t2015c\n).\tRates\tof\tcongenital\ttoxoplasmosis\tin\tthe\tUnited\nStates\tare\tunknown\t(it\tis\tnot\ta\treportable\tdisease)\tbut\tare\testimated\tat\t400\tto\t4000\tcases/year\t(\nCox\nand\tPhelan,\t2009a\n).\tAlthough\tpresent\tin\tall\tcountries,\tthe\tprevalence\tvaries\tconsiderably.\n\tHighest
|
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Highest\nrates\tof\tcongenital\ttoxoplasmosis\tare\tfound\tin\tsome\tcountries\tin\tSouth\tAmerica,\tthe\tMiddle\tEast,\nand\tAfrica\t(\nTorgerson\tand\tMastroiacovo,\t2013\n).\nSymptoms\tare\toften\tmild,\tflu-like,\tand\tunrecognized,\talthough\tpeople\twith\timmunosuppression\tcan
|
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0.11499309539794922,
0.021511422470211983,
0.0847298726439476,
0.021626926958560944
] |
have\tchorioretinitis\tand\tencephalitis.\tClinical\ttoxoplasmosis\tis\trare\tin\tthe\tUnited\tStates,\tand\t90%\tof\npregnant\twomen\twho\tare\tinfected\thave\tno\tnoticeable\n\tsymptoms\t(\nCox\tand\tPhelan,\t2009a\n).\tHowever,\neven\twithout\tmaternal\tsymptoms,\tthe\tfetus\tcan\tbecome\tinfected.\tOverall\ttransmission\trates\tappear
|
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] |
to\tbe\t20%\tto\t50%\tbut\tvary\tby\ttrimester,\tincluding\t10%\tto\t15%\tin\tthe\tfirst\ttrimester,\t25%\tin\tthe\nsecond,\tand\tover\t60%\tin\tthe\tthird\ttrimester\t(\nACOG,\t2015c\n).\tAlthough\ttransmission\tis\tlowest\tin\tthe\nfirst\ttrimester,\tthe\tseverity\tis\talso\thighest\tand\tas\tmany\tas\t90%\n\tof\tthose\texposed\twill\teventually
|
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of\tthose\texposed\twill\teventually\ndevelop\tsequelae,\teven\twithout\tclinical\tsigns\tat\tbirth.\tThe\trisk\tof\tpassing\tthe\tparasite\tto\tthe\tfetus\tis\nreduced\tgreatly\tif\tthe\tmother\thas\tbeen\tpreviously\texposed\tand\tis\talready\tseropositive.\tAlthough\nsome\tcountries\t(including\tFrance,\tAustria,\tItaly,\tPortugal,\tand\tUruguay)\troutinely\tscreen\tpregnant\nwomen\t(
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] |
women\t(\nOz,\t2017\n),\tthis\tis\tnot\tstandard\tpractice\tin\tthe\tUnited\tStates\n\texcept\tfor\tthose\twith\tHIV\tor\nimmunosuppression\t(\nACOG,\t2015c\n).\nCommonly\twomen\tare\tencouraged\tto\tnot\thandle\tused\tkitty\tlitter\twhen\tpregnant,\tbecause\tthe\tcat\tis\nthe\tdefinitive\thost\tfor\t\nToxoplasma.\n\tHowever,\ta\tcat\tpasses\tthe\toocysts\tfor\tonly\ta\tfew\tweeks\tin\tits
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] |
However,\ta\tcat\tpasses\tthe\toocysts\tfor\tonly\ta\tfew\tweeks\tin\tits\nlifetime.\tIn\taddition,\tthese\toocysts\tare\tinfective\tonly\tafter\tbeing\texposed\tto\tthe\tenvironment\tfor\tat\nleast\ta\tday.\tIf\tthe\tlitter\tbox\tis\tchanged\n\tdaily,\tthere\tis\tlittle\tdanger,\teven\tif\tthe\tcat\twere\tinfected\tand\npassing\tthe\teggs.\tCats\tshould\tbe\tkept\tindoors\tand\tnot\tfed\traw\tmeat.
|
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] |
passing\tthe\teggs.\tCats\tshould\tbe\tkept\tindoors\tand\tnot\tfed\traw\tmeat.\nBecause\tthe\toocysts\tcan\tlive\tin\tthe\tenvironment\tfor\tyears,\twater,\tdust,\tinsects,\tand\tgarden\tsoil\tcan\nalso\tbe\tcontaminated.\tFruits\tand\tvegetables\tmust\tbe\twashed,\tand\tcontaminated\twater\tshould\tnot\tbe\ningested.\tGloves\tshould\tbe\tused\twhen\tgardening.\nMeats\tand\tmilks
|
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] |
ingested.\tGloves\tshould\tbe\tused\twhen\tgardening.\nMeats\tand\tmilks\n\talso\tcan\tbe\tinfected\twith\ttissue\tcysts,\tand\tit\tis\testimated\tthat\tup\tto\thalf\tthe\tcases\nof\ttoxoplasmosis\toccur\twith\thandling\tor\teating\tundercooked\tor\traw\tinfected\tmeats,\tespecially\twild\ngame\tand\tthose\tmeats\tlabeled\t“free-range”\tor\torganic\t(\nJones\tand\tDubey,\t2012\n).\tOysters,\tclams,\tand
|
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Jones\tand\tDubey,\t2012\n).\tOysters,\tclams,\tand\nmussels\tcan\tbe\tcontaminated\tthrough\twater\trunoff.\tUnpasteurized\tgoat,\tcamel,\tand\tdonkey\tmilk\tare\nalso\tknown\tsources\n\t(\nOz,\t2017\n),\tas\tare\thomemade\tcured,\tdried,\tand\tsmoked\tmeats.\tThe\tinjected\tsalt
|
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] |
solution\tthat\toften\tis\tused\tin\tpork\tand\tchicken\twill\tkill\ttissue\tcysts,\tas\tmay\tfreezing\tthe\tmeat\tfor\ta\nfew\tdays.\tCooking\twill\tkill\tthe\tparasite,\tbut\tminimum\ttemperatures\tmust\tbe\tachieved\t(\nBox\t14.8\n).\nBOX\t14.8\nToxoplasma\n\t\nGuidelines\n•\t\nFollow\tthe\tgeneral\tfood\tsafety\tguidelines\tfrom\t\nBox\t14.5\n.\n•\t\nFreeze\tmeats\tfor\n\tseveral\tdays\tbefore\tcooking.\n•
|
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] |
Box\t14.5\n.\n•\t\nFreeze\tmeats\tfor\n\tseveral\tdays\tbefore\tcooking.\n•\t\nWash\thands\tafter\thandling\traw\tmeats.\n•\t\nCook\tmeats\tto\tat\tleast\t150°\tF\t+\t3-minute\trest\t(whole\tcuts),\t160°\tF\t(ground\tmeats,\twild\ngame),\tor\t165°\tF\t(poultry).\tThese\ttemperatures\tmay\tbe\thigher\tthan\tthe\tUSDA\trecommends
|
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] |
for\tother\tpathogens.\tDo\tnot\tsample\tmeat\tuntil\tit\tis\tcooked.\tMeats\tthat\tare\tsmoked,\tcured\tin\nbrine,\tor\tdried\tmay\tstill\tbe\tinfectious.\n•\t\nRaw\toysters,\tmussels,\n\tand\tclams\tshould\tnot\tbe\teaten.\n•\t\nKeep\tchildren’s\tsandboxes\tcovered\twhen\tnot\tin\tuse.\n•\t\nWear\tgloves\twhen\tgardening\tor\thandling\tsand\tfrom\ta\tsandbox.\tWash\thands\tthoroughly\nafterward.\n•
|
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] |
afterward.\n•\t\nPeel\tor\tthoroughly\twash\tfruits\tand\tvegetables\tbefore\teating.\n•\t\nAvoid\tunpasteurized\tmilk,\tincluding\tgoat’s\tmilk.\n•\t\nDo\tnot\tdrink\twater\tfrom\tthe\tenvironment\tunless\tit\tis\tboiled.\n•\t\nKeep\tyour\tcats\tindoors.\tDo\tnot\tfeed\n\tthem\traw\tor\tundercooked\tmeats\tor\tunpasteurized\tmilks.\n•
|
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] |
them\traw\tor\tundercooked\tmeats\tor\tunpasteurized\tmilks.\n•\t\nClean\tthe\tlitter\tbox\tdaily.\tIf\tpossible,\thave\tsomeone\telse\tchange\tthe\tlitter\tbox.\tIf\tnot,\twear\ngloves\tand\twash\thands\twith\tsoap\tand\twarm\twater\tafterward.\n•\t\nDo\tnot\tadopt\ta\tnew\tcat\twhile\tpregnant\tnor\thandle\tstrays,\tespecially\tkittens.\n•\t\nControl\trodents\tand\tother\tpotential\tintermediate\thosts.
|
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] |
•\t\nControl\trodents\tand\tother\tpotential\tintermediate\thosts.\n•\t\nIf\tbutchering\twild\tgame\tor\tvenison,\tbury\tthe\n\torgans\tso\tthat\twild\tcats\tcannot\teat\tthem\tand\nspread\tthe\tinfection.\nAdapted\tfrom\tCox\tJT,\tPhelan\tST:\tFood\tsafety\tin\tpregnancy,\tpart\t1:\tputting\trisks\tinto\tperspective,\nContemporary\tOb/Gyn
|
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] |
Contemporary\tOb/Gyn\n\t54:44,\t2009a;\tJones\tJL,\tDubey\tJP:\tFoodborne\ttoxoplasmosis,\t\nClin\tInfect\tDis\n\t55:845,\n2012.\nGuide\tfor\teating\tduring\tpregnancy\nRecommended\tfood\tintake\nThe\tincreased\tnutrient\trequirements\tof\tpregnancy\tcan\toften\tbe\tmet\tby\tfollowing\tthe\tDaily\tFood\nGuide\t(\nTable\t14.15
|
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] |
Guide\t(\nTable\t14.15\n).\tThe\tUSDA\tMyPlate\tPlan\tcan\tbe\tused\tinteractively\tonline.\tAlthough\tit\tcan\tbe\ta\nstarting\tpoint,\tit\tis\tdesigned\tfor\tthose\twomen\twith\tuncomplicated\tpregnancies.\tIn\taddition,\tunless\nvery\tnutrient-dense\tfoods\tare\tchosen,\tit\tis\n\tlikely\tto\tbe\tdeficient\tin\tiron,\tvitamin\tD,\tvitamin\tE,\tcholine,\npotassium,\tand\tDHA\t(
|
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0.012501990422606468,
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0.07612388581037521,
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0.015931595116853714,
0.04977283999323845,
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0.003081458155065775,
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0.033043794333934784,
0.08840729296207428,
0.05995071679353714,
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] |
potassium,\tand\tDHA\t(\nCenter\tfor\tNutrition\tPolicy\tand\tPromotion\t[CNPP],\t2018\n).\t\nBox\t14.9\n\tprovides\ta\nsummary\tof\tnutritional\tcare.\tWeight\tgain\tand\tfetal\tgrowth\tshould\tbe\tmonitored\tand\tthe\tplan\nmodified\tas\tneeded.
|
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0.018783006817102432
] |
TABLE\t14.15\nDaily\tFood\tGuide:\tRecommended\tServings\tfor\ta\tWoman\tPregnant\twith\ta\tSingleton\tor\tLactating\nPREGNANT\tWOMAN\t(NORMAL\nWEIGHT,\t30\tMINUTES\nEXERCISE/WEEK)\nLACTATING\tWOMAN\t(NO\nFORMULA\nSUPPLEMENTATION)\nFood\tGroup\nFirst\nTrimester\nSecond\nTrimester\nThird\nTrimester\nEarly\nLactation\n(0-6\tmos)\nLater\nLactation\n(6+\tmos)\nServing\nSizes\t(1)\nTotal\tdaily
|
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] |
(0-6\tmos)\nLater\nLactation\n(6+\tmos)\nServing\nSizes\t(1)\nTotal\tdaily\ncalories\n1800\n2200\n2400\n2130\n2200\nMeat\tand\nbeans,\toz\n5\n6\n6.5\n7\n6\n1\toz\t=\t1\toz\nmeat,\npoultry,\tor\nfish,\t1\negg,\t¼\tc\nbeans,\t½\noz\tnuts,\t¼\nc\ttofu\nMilk\tproducts,\ncups\n3\n3\n3\n3-4\n3\n1\tc\t=\t1\tc\tmilk\nor\tyogurt,\n1.5\toz\nhard\ncheese,\t2\nc\tcottage\ncheese\nBreads,\tgrains,\noz\t–\thalf\nshould\tbe\nwhole\tgrains
|
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] |
c\tcottage\ncheese\nBreads,\tgrains,\noz\t–\thalf\nshould\tbe\nwhole\tgrains\n6\n7\n8\n8\n9\n1\toz\t=\t1\tslice\nbread,\t½\tc\ncooked\nstarch,\t1\tc\nRTE\ncereal\nFruits\tand\nVegetables\n(cups)\n4\n5\n5\n6\n6\n1\tc\t=\t1\tc\traw\nor\tcooked\nfruit\tor\nvegetable,\n½\tc\tdried\nfruit,\t2\tc\nleafy\nvegetables\nVitamin\tC\trich\n1\n1\n1\n1\n1\nBeta-carotene\nrich\n1\n1\n1\n1\n1\nFolate\trich\n1\n1\n1\n1\n1\nOthers\n1\n2\n2\n3\n3
|
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] |
1\nBeta-carotene\nrich\n1\n1\n1\n1\n1\nFolate\trich\n1\n1\n1\n1\n1\nOthers\n1\n2\n2\n3\n3\nFats\tand\toils,\ntsp\n6\n7\n8\n8\n8\nIncluded\tare\nthose\nfoods\nnaturally\nhigh\tin\nfats,\nincluding\nolives,\navocados,\nand\n\tnuts\nExtras,\tcalories\n290\n360\n410\n330\n400\nHigh\tfat\tor\nsugar\nfoods\tor\nhigher\namounts\nof\tfoods\nfrom\tthe\nother\ngroups\nBeverages\n10\tc\twater/day\t(watch\turine\tcolor)
|
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] |
from\tthe\nother\ngroups\nBeverages\n10\tc\twater/day\t(watch\turine\tcolor)\n8-12\tglasses\twater\tor\tother\nbeverage\t(drink\tto\tsatisfy\nthirst)\n8\toz.\n(1)\tSee\tthe\tChooseMyPlate\twebsite\tfor\tmore\texamples.\nRTE\n,\tReady\tto\teat.\nAdapted\tfrom\t\nAmerican\tCollege\tof\tObstetricians\tand\tGynecologists\t(ACOG):\n\tNutrition\tduring\n\tPregnancy.\tPatient\tEducation\tPamphlet\tAP001,
|
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] |
Nutrition\tduring\n\tPregnancy.\tPatient\tEducation\tPamphlet\tAP001,\nSeptember\t2012;\tUSDA:\tWhat\tis\tMyPlate,\tJuly\t2018.\t\nhttps://www.choosemyplate.gov/MyPlate\n.
|
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] |
BOX\t14.9\nSummary\tof\tNutritional\tCare\tDuring\tPregnancy\n1.\t\nA\tvariety\tof\tfoods,\tfocusing\ton\tnutrient-dense\tfood\tchoices\n2.\t\nEnergy\tintake\tto\tallow\tfor\tappropriate\tweight\tgain\n3.\t\nProtein\tintake\tto\tmeet\tnutritional\tneeds,\tapproximately\tan\tadditional\t25\tg/day;\n\tadditional
|
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] |
additional\n50\tg/day/fetus\tif\tpregnant\twith\tmore\tthan\tone\tfetus.\tThis\toften\trequires\t20%\tof\tenergy\nintake\tfrom\tprotein\n4.\t\nDHA\tfrom\tfatty\tfish\t(low\tin\tmethylmercury)\ttwice\ta\tweek\n5.\t\nMineral\tand\tvitamin\tintakes\tto\tmeet\tthe\trecommended\tdaily\tallowances.\tFolic\tacid\nsupplementation\tis\toften\trequired;\tiron\tsupplementation\tmay\tbe\tnecessary\n6.
|
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] |
6.\t\nSodium\tintake\tthat\tis\tnot\texcessive\tbut\tnot\tless\tthan\t2300\n\tmg/day.\tIodized\tsalt\tis\nrecommended\n7.\t\nSufficient\tfluid\tintake\tto\tproduce\tdilute\turine,\tusually\tat\tleast\t2\tL/day\n8.\t\nAlcohol\tomitted\n9.\t\nOmission\tof\ttoxins\tand\tnonnutritive\tsubstances\tfrom\tfood,\twater,\tand\tenvironment\tas\tmuch\nas\tpossible\nFluids
|
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as\tpossible\nFluids\nDrinking\t8\tto\t10\tglasses\tof\tquality\tfluid\tdaily,\tmainly\twater,\tis\tencouraged.\tThe\tDRI\tfor\tfluid\nincreases\tslightly\tduring\tpregnancy,\tbut\ta\twoman’s\n\tbody\tsize\tas\twell\tas\tclimate\tconditions\tare\nimportant\tconsiderations.\tAdequate\thydration\timproves\tthe\toverall\tsense\tof\twell-being.\tFrequent
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urination\tis\toften\ta\tcomplaint\tfrom\tpregnant\twomen.\tHowever,\toptimal\thydration\treduces\trisks\tfor\nurinary\ttract\tinfections,\tkidney\tstones,\tand\tconstipation.\tIn\taddition,\tdehydration\tcan\tcause\tuterine\nirritability.\tWomen\toften\tmust\tbe\treminded\tto\tpay\tattention\n\tto\ttheir\tintake\tof\tliquids,\tusing\turine\ncolor\tafter\tthe\tfirst\tmorning\tvoid\tas\ta\tguide.
|
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compromised\tthe\tnutritional\tstatus\tof\tthe\twoman,\tthe\tgreater\tthe\tbenefit\tfor\tpregnancy\n\toutcome\nwith\timproved\tdiet\tand\tnutrient\tsupplementation.\tAmong\twomen\tin\tlow-\tand\tmiddle-income\ncountries,\tsupplementation\tof\tboth\tmicronutrients\tand\tmacronutrients,\tincluding\tbalanced\tprotein-
|
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energy\tsupplements\tas\twell\tas\tlipid\tsupplements,\tcan\timprove\tfetal\tgrowth\tand\tbirth\toutcomes\n(\nVaivada\tet\tal,\t2017\n),\tincluding\ta\treduced\trisk\tof\tpreterm\tbirths\t(\nHeidkamp\tet\tal,\t2017\n).\tIt\tis\tunclear,\nhowever,\n\tif\tsupplementation\tbenefits\tfetal\tgrowth\tif\tthe\tmaternal\tstatus\tis\tnot\tcompromised\t(\nda\tSilva\nLopes\tet\tal,\t2017
|
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da\tSilva\nLopes\tet\tal,\t2017\n).\tIn\tthe\tUnited\tStates\tpregnant\twomen\tat\tnutritional\trisk\tare\tencouraged\tto\tenroll\nin\tthe\tSpecial\tSupplemental\tNutrition\tProgram\tfor\tWomen,\tInfants,\tand\tChildren\t(WIC),\nadministered\tby\tthe\tUSDA.\tThe\tWIC\tprogram\tserves\teligible\tpregnant\twomen\tand\tbreastfeeding\n(until\t1\tyear\tpostpartum)
|
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] |
(until\t1\tyear\tpostpartum)\n\tand\tnonbreastfeeding\twomen\t(until\t6\tmonths\tpostpartum),\tas\twell\tas\ninfants\tand\tchildren\t(up\tto\tage\t5).\tFor\twomen,\t“nutritional\trisk”\tcriteria\tmay\tinclude\tanemia,\tpoor\ngestational\tweight\tgain,\tand\tinadequate\tdiet,\tas\twell\tas\ta\tvariety\tof\tpreexisting\tmedical\tconditions.
|
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] |
WIC\tprovides\ttargeted\tsupplemental\tfoods,\tnutrition\teducation,\tand\tbreastfeeding\tsupport\tas\twell\tas\nhealth\tcare\treferrals.\tOutcome\n\tstudies\tshow\timproved\tbirth\tweights\tand\thigher\tmean\tgestational\nages\tin\tinfants\tborn\tto\tWIC\tparticipants.\nThe\tgoal\tfor\tnutritional\tsupplementation\tis\tto\tconsume\tthe\tnecessary\tnutrients\tas\tfood,\ttaking
|
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0.07388415932655334,
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] |
those\twith\ta\thistory\tof\tbariatric\tsurgery,\tteenage\tmothers,\twomen\twith\tsubstance\tabuse,\twomen\nwith\ta\tshort\tinterval\tbetween\tpregnancies,\twomen\twith\ta\thistory\tof\tdelivering\tan\tinfant\twith\tLBW,\nand\tthose\tpregnant\twith\tmultiple\tfetuses.\tPreconceptual\tsupplementation\tis\trecommended\tfor\tfolic\nacid\tand\tmay\tbe\twarranted
|
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acid\tand\tmay\tbe\twarranted\n\tfor\tother\tnutrients\tas\twell.\tCurrent\tresearch\tis\texamining\twhich\nmicronutrients\tare\tmost\tcritical\tto\tinclude\tin\tthe\tmultivitamin-multimineral\tsupplements\t(\nda\tSilva\nLopes\tet\tal,\t2017\n).\nMany\tpregnant\twomen\thave\tlimited\tknowledge\tregarding\tthe\tnutrients\tin\tthe\tdietary\tsupplements
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they\thave\tbeen\tadvised\tto\tpurchase.\tDietary\tsupplements\tare\tnot\tregulated\tas\tdrugs\tin\tthe\tUnited\nStates\t(\nBinns\tet\tal,\t2018\n).\tThere\tis\tno\tstandard\tdefinition\tof\twhat\ta\tdietary\tsupplement\tlabeled\n“prenatal\tvitamin”\tmust\tcontain\tand\tthe\tcontents\tvary\twidely.\tHaving\tit\tbe\tavailable\tby\tprescription
|
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does\tnot\timply\tthat\tthe\tsupplement\tis\tbetter,\tnor\tsafer,\tnor\tthat\tit\tcontains\thigher\tlevels\tof\tany\nparticular\tnutrient\t(\nSaldanha\tet\tal,\t2017\n).\tIn\tfact,\ta\trecent\tstudy\tfound\tthose\tprenatal\tsupplements\navailable\tover-the-counter\n\tactually\tcontain\tmore\tnutrients\tthan\tmany\tof\tthe\tsupplements\tavailable
|
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] |
only\tby\tprescription.\tIt\tis\timportant\tto\tread\tthe\tlabel\ton\tprenatal\tsupplements\tbecause\tsome\tare\nmuch\tmore\tcomplete\tthan\tothers,\tand\tsome\tinclude\tingredients\tin\taddition\tto\tthe\tvitamins\tand\nminerals.\tWomen\toften\tneed\tadvice\ton\tlocal,\tsuitable\tchoices.\tLook\tfor\tthose\tthat\tcontain\tthe\tUnited\nStates\tPharmacopeia\t(USP),\tConsumer
|
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] |
States\tPharmacopeia\t(USP),\tConsumer\n\tLabs,\tor\tNational\tSanitation\tFoundation\t(NSF)\tseals\tof\napproval\tfor\tquality\t(not\tsafety\tor\teffectiveness)\t(see\t\nChapter\t11\n).\tA\tbalanced\tprenatal\tsupplement\nshould\tcontain\t400\tto\t800\tmcg\tof\tfolic\tacid\tand\talso\tshould\tcontain\tiron\tunless\tcontraindicated.
|
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] |
Caution\tis\tadvised\twith\tthe\tuse\tof\tthe\tprenatal\tgummies\tbecause\tthey\tseldom\tcontain\tiron.\tCopper\tis\nrecommended\tif\tthe\tsupplement\talso\tcontains\n\tzinc\tor\tiron\t(\nUriu-Adams\tet\tal,\t2010\n).\tThe\tsupplement\nshould\tcontain\t150\tmcg\tof\tiodine\tin\tthe\tform\tof\tpotassium\tiodide,\tnot\tkelp\tor\tseaweed\t(\nLeung\tet\tal,\n2013
|
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Leung\tet\tal,\n2013\n).\tAlthough\tsome\tcontain\tDHA,\tat\tleast\tas\tmuch\tbenefit\tcan\tcome\tfrom\tincluding\thigh\tDHA\tfish
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0.021877186372876167,
0.036791689693927765,
0.01778416335582733
] |
regularly\tin\tthe\tdiet\t(see\t\nFocus\tOn:\n\tOmega-3\tFatty\tAcids\tin\tPregnancy\tand\tLactation\n).\nThose\tsupplements\tcontaining\tnutrient\tlevels\tmuch\thigher\tthan\n\tthe\tDRI\tare\tnot\trecommended\nbecause\tof\tknown\tteratogenic\teffects\t(e.g.,\tpreformed\tvitamin\tA),\tas\twell\tas\tpotential\tepigenetic
|
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] |
effects.\tSome\tcontain\tmany\tadditional\tingredients,\tincluding\therbal\tpreparations,\tmany\tof\twhich\nhave\tnot\tbeen\tevaluated\tfor\tsafety\tduring\tpregnancy\tand\tmay\tbe\tcontraindicated,\tespecially\tduring\nthe\tfirst\ttrimester.\nAs\ta\treminder,\tprenatal\tmultivitamins-multiminerals\tmay\n\tbe\tmore\tcritical\twhen\ta\twoman’s
|
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] |
be\tmore\tcritical\twhen\ta\twoman’s\nnutritional\tstatus\tis\tat\trisk.\tFor\tothers,\tthey\tmay\tbe\tused\tas\tinsurance\tbut\tshould\tnot\tbe\tused\tas\ta\nsubstitute\tfor\teating\twell.\tWhether\tprenatal\tmultivitamin-multimineral\tsupplements\tare\tnecessary\nfor\twomen\tliving\tin\taffluent\tsocieties\tis\tdebated,\tbut\ttheir\tuse\tis\tcommon.\tFor\twomen\tliving\tin\tlow-
|
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] |
and\tmiddle-income\tconditions,\tprenatal\tsupplementation\thas\tbeen\tassociated\n\twith\tbetter\tbirth\noutcomes\t(\nVaivada\tet\tal,\t2017\n).\nNutrition\teducation\nNutrition\tintervention,\tincluding\tmedical\tnutrition\ttherapy\t(MNT),\thas\tbeen\teffective\tin\timproving\nthe\tmaternal\tdiet,\treducing\tthe\trisk\tof\tanemia\tin\tlate\tpregnancy,\tand\timproving\tgestational\tweight
|
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gain,\tthus\tlowering\tthe\trisk\tof\tpreterm\tbirth\tand\timproving\tinfant\thead\tcircumference\tsize\tand\tbirth\nweight\t(\nBlondin\tand\tLoGiudice,\t2018\n).\tFor\tlow-income\trecipients\tat\trisk\tfor\tlow\tgain\tand\ttherefore\npoor\tfetal\tgrowth\tand\tpreterm\tdelivery,\tresults\tare\tenhanced\tif\teducation\tis\tcombined\twith\tbalanced
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energy\tand\tprotein\tsupplementation\tand/or\tmicronutrient\tsupplements.\tAmong\twomen\twho\tare\noverweight\tand\tobese,\tdietary\tand\tlifestyle\tadvice\tresults\tin\ta\tsignificant\treduction\tin\tthe\trelative\nrisk\tof\tdelivering\tan\tLGA\tinfant,\n\twith\tno\tincrease\tin\tthe\trisk\tof\tdelivering\tan\tSGA\tbaby,\teven\tif\tthere\nis\tno\teffect\ton\tmaternal\tweight\tgain\t(
|
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] |
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