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Could some miscarriages be prevented?

By Dr Cory Couillard

Having a miscarriage is often a painful experience for couples to overcome, both physically and mentally. Overall, about 12 to 15 per cent of clinically recognised pregnancies end in miscarriage — with the occurrence increasing with maternal age.
Miscarriage is defined by the World Health Organisation (WHO) as the premature loss of a foetus up to 23 weeks of pregnancy and weighing up to 500 grams. The occurrence at 20 years of age is about 10 per cent and increases to more than 90 per cent among women 45 years of age or older.
A new report published in the International Journal of Obstetrics and Gynaecology indicates that 25.2 per cent of miscarriages could be prevented by a combination of lifestyle changes. Modifiable risk factors such as underweight, obesity and alcohol consumption appear to have the greatest impact on miscarriage.
The study that consisted of 91,427 pregnancies highlighted the importance of eating a balanced diet, limiting substances of abuse such as alcohol, and not lifting over 20 kilogrammes per day while pregnant, or working at night.
Women wanting to conceive should also eat a balanced diet, make sure they are not “too skinny”, or overweight, cut out smoking and ask their partners to follow suit, said Caroline Overtone, spokesperson at the Royal College of Obstetricians and Gynaecologists.
Related research published in the Journal of the American Medical Association suggests folic acid can also reduce the risk of early miscarriage. In the study, women with low levels of folic acid were 50 per cent more likely to have a miscarriage than women with normal levels.
Folic acid is a vitamin that is required for the proper growth and development of an embryo. All women of childbearing age should consume folic acid daily.
According to the Institute of Medicine, “women capable of becoming pregnant should take 400 microgrammes of synthetic folic acid daily, from fortified foods or supplements or a combination of the two, in addition to consuming food with folate from a varied diet.”
Women who get at least 400 microgrammes can reduce their unborn baby’s risk of neural tube defects by as much as 70 per cent. Birth defects such as spina bifida and anencephaly can be prevented as well as placental separation during pregnancy, pregnancy-induced hypertension, and low blood supply to the placenta.
Excessive alcohol intake, as found in the study, has been shown to destroy folic acid and damage the lining of the digestive system — reducing one’s ability to absorb nutrients.
Poor nutrient absorption can play a significant role in the development of many health conditions that can impact miscarriage and the overall health of the mother and child. Without addressing the causative factors, ie diet and alcohol consumption, many women taking medications can further deplete folic acid.
According to the University of Maryland Medical Centre, “several types of drugs can cause folic acid depletion. These drugs include antacids, anti-inflammatory medicines like aspirin and naproxen, antibiotics, anti-convulsants such as barbiturates, birth control medications, diuretics, ulcer medications, cholesterol-lowering medications and the anti-diabetic medication metformin.”
Folic acid is naturally found in fruits like lemons, bananas and melons as well as leafy-green vegetables like spinach, broccoli and lettuce. Beans, peas and lentils also provide high amounts of this protective nutrient. Folic acid is added to many breads, juices and cereals during processing and is labelled as ‘enriched’ or ‘fortified’.
Lastly, to prevent potential miscarriage, practice safe sex and get screened for sexually transmitted infections (STIs). Untreated STIs such as gonorrhoea, syphilis, HIV and herpes can increase the risk of miscarriage.

Dr Cory Couillard is an international health columnist that works in collaboration with the World Health Organisation’s goals of disease prevention and control. Views do not necessarily reflect endorsement.

E-mail: drcorycouillard
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