High-risk medical conditions during pregnancy

Morning sickness is a miserable nuisance that occurs in 50 percent of all pregnancies.

by Dr. Denise Grobe — 

Several studies suggest that the standard American diet and corresponding increased incidence of obesity are at least partly responsible for the growing number of patients with gestational diabetes (GDM), preeclampsia and morning sickness during pregnancy. Educating the public about the importance of diet and lifestyle, particularly during pregnancy, is a top priority, as well as providing the tools to be successful.

Morning sickness, gestational diabetes and preeclampsia

Morning sickness is a miserable nuisance that occurs in 50 percent of all pregnancies. Severe cases may cause weight loss, dehydration and hypokalemia (low potassium), but there are no known adverse affects to the baby. Some theorize that morning sickness is due to changes in hormones. Research suggests that women who eat a diet higher in sugars, oils, artificial sweeteners, processed foods and caffeine are more likely to develop morning sickness during pregnancy.

Gestational diabetes results in high blood sugar levels during pregnancy, when there is an increased demand on insulin to manage blood sugar levels. There are no common symptoms of GDM, and it is usually diagnosed by a general screening during pregnancy.

Complications if blood sugars are not well maintained can include:

• Large babies, which can complicate delivery, cause trauma to both baby and mother, and increase the incidence of C-sections.
• When mothers have low blood sugar, babies have difficulty managing blood sugar levels after delivery.
• Jaundice, polycythemia (high blood cell mass), and low calcium and magnesium levels can result.
• Imbalanced blood sugars interfere with lung maturation and increased association with preeclampsia.

Women who have had GDM are at increased risk of developing type 2 diabetes at a later time. Children of women who had GDM are at increased risk of childhood and adult obesity, type 2 diabetes and insulin resistance. This risk is most significant when blood sugars were not well managed during pregnancy.

Preeclampsia is hypertension during pregnancy associated with high levels of protein in the urine. The exact cause of preeclampsia is unknown, but it is well accepted that preeclampsia arises from multiple factors. Diet is believed to be a major factor, especially relating to poor nutrition, vitamin deficiencies and obesity.

Signs and symptoms of preeclampsia include rapid weight gain caused by a significant increase in bodily fluid, abdominal pain, severe headaches, a change in reflexes, dizziness, and reduced output of urine or no urine.

Complications of preeclampsia can include:

• Lack of blood flow to the placenta, which can cause slow growth, low birth weight, preterm birth and breathing difficulties for the baby.
• Increased risk of placental abruption.
• HELLP syndrome, a group of symptoms that occur in pregnant women who have: H (hemolysis or the destruction of red blood cells); EL (elevated liver enzymes); LP (low platelet count). Symptoms include headache, nausea and vomiting that continues to get worse and can rapidly become life-threatening to mother and baby.
• Eclampsia is preeclampsia with seizures, and it can permanently damage vital organs, including the brain, liver and kidneys. Left untreated, it can cause coma, brain damage and death to mother and baby.

Women who develop preeclampsia have an increased risk of cardiovascular disease later in life.

Diet and lifestyle changes implemented before pregnancy or during early pregnancy can greatly reduce the risks of developing these pregnancy-related conditions. Adopting a low-glycemic diet will manage blood sugar by limiting levels to a narrow range and improving insulin response. A low-glycemic diet consists of mostly whole foods and limits processed foods, which improves dietary intake of vitamins and minerals.

What is a low-glycemic diet?

The glycemic index refers to the effect a food has on blood sugar levels. Foods with a high-glycemic index (above 70) raise blood sugar levels significantly, while foods with a low index (below 55) cause only a small increase in blood sugar levels. So a diet consisting of low-glycemic foods will keep blood sugar and insulin levels low and well stabilized.

Research has shown that people who adhere to a low-glycemic diet have a decreased risk of developing type 2 diabetes and cardiovascular disease.

It is important for women with a history of or who are at higher risk for morning sickness, preeclampsia and gestational diabetes to look at altering their lifestyles to healthier ones. Many programs are available that focus on low-glycemic meal planning, exercise, specialized supplementation and personalized support.

Dr. Denise Grobe, a naturopathic physician, directs the FirstLine Therapy program at the Center for True Harmony Wellness & Medicine™ in Mesa, Ariz. 480-539-6646 or www.trueharmonywellness.com.

Reprinted from AzNetNews, Volume 30, Number 5, Oct/Nov 2011.