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Dr. Magryta: prenatal health

Prenatal health is unfortunately a major concern for pediatricians based on the preponderance of research showing that poor maternal micro- and macronutrient states are a root cause of much disease for her child.

Part 1:

It is very clear now that mothers that are overweight, have insulin resistance and high blood pressure thereby using drugs to control their disease have increased risks of perinatal complications, premature births and less healthy offspring.

The reasons are multifactorial from excessive insulin hormone circulating in the placenta affecting the baby, to an abnormal maternal gut microflora that colonizes the child at birth starting a negative cascade of events that predispose the child to obesity, allergy and auto immune diseases.

What is less clear is how micronutrients like minerals and vitamins work as a class effect to the whole population. I am sure that every mother has a different response to the standard micronutrient supplement known as the prenatal vitamin. We know that folic acid (B9) supplementation reduces the risk of neural tube defects in babies. That is a good thing. But is there a downside? (it gets dense here – skip to the recommendations if you don’t like the sciencey part of my newsletters)

There has been some research to say YES. For example, a recent study from Johns Hopkins School of Medicine by Dr. Fallin and colleagues showed a significant risk for an offspring developing autism if the maternal blood levels of vitamins B9 and B12 were elevated. The study does not discuss causation just association.

And the research also says NO! There are other studies like the study by Schmidt from Epidemiology in 2011 that showed that mothers with certain genetic mishaps like MTHFR who did not supplement with extra B9 the few months before conceiving a child and the month after conception had significant risks to bear a child with autism, especially if the child had a gene defect called COMT. I would like to see the MTHFR and COMT status of the Hopkins group to see if the Autism subgroup had mothers with elevated B vitamins because of genetic SNP’s like MTHFR and COMT. I bet this is the case.

Confused yet! I am.

What I can decipher from the research is that it is complicated and knowing your genes would help to personalize the situation and potentially mitigate a bad outcome. If a mother has an MTHFR gene defect, she will not metabolize folic acid well but may do well with methylated folate.

Let me be clear here. We are at the infancy stage of understanding these issues known as “one carbon metabolism”. We are not ready to make blanket recommendations. This is all early theory but still valuable.

Boiling it all down. As of today, these are the recommendations that I can make for every mother to be in order to maximize the health of their newborn:

1) Food is the key – the maternal diet should begin to change before you plan to conceive in order to set up a healthy ecosystem in the gut and blood stream. ( this may help you conceive as well) Food should be whole, diverse and unprocessed. Severely limit the consumption of flour and sugar to control insulin levels and reduce inflammation. Fat is good. Eat lots of avocados, nuts, seeds, oily fish and coconut. Meat is good if it is farm raised, grass fed and clean. Eat meat sparingly. The remainder of your plate should be tons of fruits and vegetables.

2) Mild to moderate exercise daily. This improves metabolism and elimination via sweat and bowels which helps clear toxic substances from the body which are known to negatively affect the fetus. Too much exercise can negatively affect your ability to get pregnant. Exercise to maintain a healthy weight.

3) Sleep and reduce stress. Nothing is more toxic to a pregnancy then stress and exhaustion. Having a child is a full time job. Be prepared. Enlist the help of your village when you get overwhelmed. Try meditation, yoga and prayer to balance the mind and body. Practicing daily gratitude is also useful. We do happen to live in the best country and have fabulous friends and neighbors.

4) For now, take your prenatal vitamins until we get a better and more personalized option. If you find out that you have an MTHFR or COMT defect, consult with a Functional Medicine doctor for advice and how to proceed.

5) Drink a lot of water. You are 65% water. Hydration is key to many cellular functions.

6) Avoid any chemical that is bad for you! See the website www.EWG.org for details. As far as I am concerned, there is no place for chemicals in a pregnant women’s life.

This topic is so important! The adage an ounce of prevention is worth a pound of cure is even more true here!

 

Dr.  Magryta is a physician at Salisbury Pediatric Associates. Contact him at  newsletter@salisburypediatrics.com

 

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