MAR

27

Pregnancy Tests and False Positives

If you’ve received a positive on a pregnancy test, congratulations! False positives are incredibly rare, though many people still mistake a negative with a positive on an analog home pregnancy test. Always make sure you read the instructions on your pregnancy test carefully!

Pregnancy tests, whether taken at home or at the doctor’s office, test for a hormone called hCG in the blood or urine. HCG is a very good indicator of pregnancy; the chemical is released by placental tissues as part of placental implantation, and remains critical throughout pregnancy.

That means that, for the most part, if you get a positive on a pregnancy test, conception has already occurred. There are a few rare cases where a test may detect chemicals other than hCG. There are also very rare situations where your pituitary or cancer cells in your body may be producing hCG. These are virtually never the cause of a “false positive.” Rather, what many women confuse with a false positive is actually a chemical pregnancy — a type of miscarriage.

HCG levels begin to rise incredibly early on in a pregnancy and some tests may detect hCG as soon as a week after conception. This is generally referred to as the “chemical” or “biochemical” phase of pregnancy — at this point, there hasn’t been enough development for the pregnancy to be detected via ultrasound or really by any method other than the presence of hCG.

The problem is, at this stage, miscarriage is common. It’s estimated that as many as 60% of all pregnancies miscarry before they become visible via ultrasound. Before the prevalence of home pregnancy tests, a woman typically wouldn’t even know when she had experienced one of these early miscarriages (usually referred to as a chemical pregnancy). Now, many women are finding themselves heartbroken over a loss they would never have known about, and some doctors are wondering if these early home pregnancy tests are a good idea.

They are. But they don’t necessarily mean what we want them to mean. These miscarriages often occur for very good reasons — reasons like chromosomal disorders or ectopic pregnancies, where the pregnancy simply isn’t viable. It can still be hard for some women to experience this loss, which is why some doctors suggest waiting longer before testing for pregnancy.

However, many women don’t begin to improve their health habits until after they know that they are pregnant. That little plus sign can be a great motivator to kick the caffeine habit, stop drinking that glass of wine with dinner, and to start taking your prenatal multivitamin. And the sooner you do those things, the healthier your baby will be!

MAR

17

What are the Risk Factors for Gestational Diabetes?

According to the CDC, gestational diabetes is a problem for approximately 9% of pregnancies. This condition can have serious and lasting side effects for both mother and baby, but many women do not know what it is. A pregnant woman is said to have gestaitonal diabetes if she has high blood sugar levels during pregnancy, but did not have diabetes before. That means gestational diabetes is a problem for women who may never had to think about diabetes and blood sugar levels before! Unfortunately, hormones released during pregnancy can raise insulin resistance and cause temporary problems with blood sugar levels.

Gestational diabetes is the last thing you want to worry about when you’re pregnant. You’re struggling enough as it is to control your diet (whether your problem is nausea, cravings, or both). Maybe you had to cut back on the coffee, give up the glass of wine with dinner, or say goodbye to your favorite cheese from Whole Foods. You’re worrying about nutritional requirements that you never cared about that much before… and now you have to be extra-careful with the carbs, too?

Unfortunately, if you are at risk for gestational diabetes, you certainly want to do everything you can to prevent it. Gestational diabetes puts both you and your baby at risk for a lot of health problems, both now and later down the line. Though your diabetes is likely to go away once your hormones return to normal, the problems gestational diabetes can bring in labor alone should motivate you to avoid it all together. Typically, that means exercise and even more of that “eating well.”

Depending on your medical history, your doctor may have already suggested screening you for gestational diabetes. If not, you may want to consider the risk factors for gestational diabetes. You don’t have to have had diabetes before in order to get gestational diabetes. If any of these are true for you, you should have a conversation with your doctor about gestational diabetes screening and prevention.

You are considered to be at a higher risk of gestational diabetes if:

You have experienced gestational diabetes before,
You have previously had a macrosomic (9lbs +) baby,
You were/are overweight,
You have a family or personal history of type 2 diabetes,
You are over 25 years of age,
You are African American, Asian American, Hispanic, Pacific Islander, or Hispanic.

If none of these things are the case, it still can’t hurt to talk to your OBGYN about gestational diabetes. It’s always better to be safe than sorry, especially when it’s your baby’s health at question. And if it turns out you’re in the clear for gestational diabetes, that’s one less thing you have to worry about!

MAR

13

Exercising While Pregnant: is it Safe?

Many women believe that exercising while pregnant is too dangerous — and then there are women who take the other extreme. One woman proudly told me about how she had kept up her habit of high-exertion hiking throughout her pregnancy, even doing a ten-mile hike the weekend before she gave birth!

As is usually the case, neither extreme is correct.

Exercise may, in fact, be quite beneficial to both you and your baby during pregnancy. However, discussing your exercise routine with your doctor is especially important when you are pregnant. Some exercises can be quite dangerous, especially nearing the end of your pregnancy. Your doctor can tell you if any factors in your pregnancy preclude exercise, or a particular exercise. Your doctor should also be able to give you an idea of what kinds of exercise are or aren’t a good idea during pregnancy – they may surprise you!

There are some basic things that you should be aware of when it comes to exercising while pregnant, though.

First of all, exercising while pregnant has definitely been shown to have its benefits. Having stronger core muscles can help with labor and with back pains. If you’re having problems with gestational diabetes, or are at risk of gestational diabetes, exercise may help. Plus, those endorphins can really boost your mood!

Second, you will be more prone to injuries while you’re pregnant. Hormones (namely relaxin) which are important for loosening your body up for labor also make you more susceptible to injuries, especially of the joints and ligaments.

Third, there are some exercises you really shouldn’t be doing while pregnant. Of course, mountain biking during your third trimester isn’t a good idea. There are also less-obvious exercises you should probably avoid during pregnancy, as well as exercises that you may be surprised to find are perfectly safe. Again, I refer to what I was saying earlier: speak to your doctor to find out what you should and shouldn’t be doing during your pregnancy. And keep in mind, many of the exercises you can safely do during your first trimester won’t be a good idea during your third trimester.

An always good rule of thumb, though: if you don’t feel right doing it, don’t do it!

MAR

4

Prenatal Vitamins Before Pregnancy

A lot of women ask when they should start taking prenatal vitamins. Our answer? Immediately.

If you’re a woman of child bearing age, it’s especially important that you get enough folic acid. Folic acid is required for proper development of the neural tube of a baby in the first few weeks after conception. That means that your baby may suffer from the effects of folic acid deficiency before you even know you’re pregnant.

Neural tube defects may be mild, like in the case of spina bifida occulta, or may be fatal, as is often the case with anencephaly.

400 mcg a day of folic acid is usually considered minimally sufficient for pregnancy. TriCare Prenatal DHA ONE contains 1 mg, or 1000 mcg, of folic acid per softgel.

According to the FDA, 2500 children are born with neural tube defects each year in the US. Read more at fda.gov

FEB

25

FDA Updating Fish Recommendations

Yesterday, the FDA took yet another step toward updating their fish consumption advice for pregnant women. They are closing their draft update to comments to begin further review.

Last year, the FDA came out with a draft update to their advice regarding fish consumption. The proposed new advice comes following an FDA analysis that found very low levels of fish consumption in pregnant women in the United States: 75% of surveyed women consumed less than half of the USDA’s recommended minimum for seafood consumption, while 20% had reported no seafood consumption at all in the last month.

The current official recommendation from the FDA for pregnant women is to consume a maximum of 12 ounces of low-mercury fish. However, the USDA has been recommending that women who are pregnant or breastfeeding consume between 8 to 12 ounces of seafood per week. The proposed update to the FDA recommendation would bring it in-line with the USDA recommendation.

Moderate fish consumption in pregnant and breastfeeding mothers has been shown to contribute positively to the health of the child, something the FDA and USDA guidelines have reported for years. Fish can be a great source of omega-3 fatty acids and other nutrients especially beneficial to a developing child, but they can also be a source of toxic levels of methylmercury and other contaminants.

The draft had received some heat last year for not emphasizing the importance of consuming fish high in omega-3s, or that the most common low-mercury seafood tends to also be low in omega-3 content. The latest version of the FDA draft update includes information comparing omega-3 content to mercury content in a variety of fish.

It remains to be seen what the final update will look like, and whether or not a change to the FDA guidelines will bring a signficant change to seafood consumption patterns. There are many reasons people don’t eat fish.

Hopefully, increasing knowledge of important nutrients during pregnancy will help women to better ensure they are getting the supplements their baby needs most.

You can view the drafted update at the FDA’s website.