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Pregnancy stress threatens the health of the unborn child - DW - 11/07/2013

11/07/2013 November 7, 2013

It is well known that severe stress is harmful. Now scientists have taken up the question of how the stress experienced by the mother during pregnancy affects the health of the child.

https://p.dw.com/p/1ADc4

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Pregnancy, even if it is not the first, in itself, of course, is a fair amount of stress. But even if this were not so, hardly any woman manages to avoid the stress caused by various events of everyday life for all nine months. And therefore, almost any expectant mother asks the question: how will the stress she experiences affect the child? Can the fear, pain, grief, irritation, or arousal of the mother be transmitted to the fetus in the womb? nine0005

Maternal stress hormone in fetal blood

Not only can they be transmitted, but they must be transmitted, although, of course, still not fully, doctors say. The placenta contains a number of hormones designed to protect the fetus from the harmful effects of cortisol, the mother's stress hormone. But it still penetrates into the blood of the embryo. True, there its concentration is about 10 times lower than the maternal one, however, it is also enough to have a significant effect on the fetal body. nine0005

And not just significant, but long-term, often even permanent. This conclusion was reached by a group of doctors led by Professor Matthias Schwab (Matthias Schwab) from the Hans Berger Neurological Clinic at the University Hospital of Jena. The scientists reported the results of their research at the 21st annual session of the German Somnological Society, which took place in Wiesbaden.

“Antenatal stress leads to a long-term increase in fetal cortisol levels and accelerates brain maturation,” says Prof. Schwab, who heads the Intrauterine Brain Development and Later Life Programming of Disease Working Group. “For this reason, the stress experienced by the mother during pregnancy , is a serious risk factor that increases the likelihood of a child developing later depression and other pathologies. nine0005

Dreaming of a lamb in the womb of a sheep

Professor Schwab and his colleagues conducted their experiments on sheep, since in these animals the course of pregnancy and the formation of the embryo have a significant similarity with the same processes in humans. Pregnant - that is, pregnant - sheep, the researchers injected betamethasone, a synthetic glucocorticoid drug related to cortisol, which is often prescribed to women with the threat of premature birth. This drug speeds up the development of the lungs in the fetus, which increases the chances of a premature baby to survive. Betamethasone was administered to pregnant sheep at a stage corresponding in pregnant women to the period between the 25th and 32nd weeks. nine0005

At the same time, scientists monitored the intrauterine brain activity of embryos using electroencephalography. It turned out that betamethazole accelerates the maturation of not only the lungs, but also the brain, says Professor Schwab: “This is evidenced, first of all, by the early appearance of dreams. Usually, the formation of dreams occurs in the last third of pregnancy, and this development occurs very gradually. And betamethasone literally includes there is some kind of toggle switch in the brain, and dreams are formed in 2-4 days. " nine0005

Brain development inhibits cell growth and division

Another consequence of the introduction of the hormone was an abnormally frequent alternation of the phases of REM and non-REM sleep. This fragmentation of sleep, if it becomes permanent, indicates a high risk of developing depression later in life and, according to Professor Schwab, is often diagnosed in newborns whose mothers experienced severe stress during pregnancy.

The problem is that the premature maturation of brain structures occurs due to a slowdown in cell division and body growth, the scientist says. This is confirmed by other doctors. "Children given injections to accelerate lung maturation showed a very significant increase in stress axis activity and had a markedly lower birth weight," says Thorsten Braun, a gynecologist at the Charité University Hospital in Berlin. nine0005

Therapy with betamethasone is fraught with behavioral disorders

In Germany, 8 to 10 percent of pregnant women receive betamethasone. The fact that this drug reduces mortality among premature babies by 31 percent has long been scientifically proven. However, animal experiments have shown that taking the drug also causes long-term side effects - in particular, hypertension - and also contributes to the development of cardiovascular diseases and diabetes in later life. nine0005

As for a person, here scientists have identified, first of all, an increased risk of developing depression and behavioral abnormalities. Recently, Professor Schwab and his colleagues examined 40 eight-year-old children who had previously undergone intrauterine therapy with betamethasone. Comparing the test results of these children with the test results of children in the control group revealed significant differences, the scientist emphasizes: ". Electroencephalography also showed that these children could not relax before testing, and could not concentrate during testing. nine0005

No reason to panic

Apparently, the increased content of the stress hormone in the blood at the stage of intrauterine development leads to the fact that the body of the embryo gets used to this situation and begins to perceive it as the norm. "These babies are already programmed in the womb to produce too much of the stress hormone later in life," says Professor Schwab.

The Dutch colleagues of the German scientist - doctors at the University of Tilburg - found that maternal stress affects the fetus most negatively between the 12th and 22nd weeks of pregnancy: its consequences make themselves felt even 20 years later. nine0005

But still, one should not panic, says Professor Schwab: “Stress during pregnancy is a completely normal thing. And injections of betamethasone, this hormonal accelerator of lung development, are an important and necessary therapy if there are indications for it. You just need to keep in mind that An elevated level of stress hormone in the blood of the embryo seems to play a more important role in the development of later diseases than has been previously believed.

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HEALTHY NUTRITION IN PREGNANCY - Outpatient Clinic

Happiness, agonizing expectation, anticipation and even fear - all these feelings inevitably accompany pregnant women. And it is very important during this period not to surrender to emotions, but to remember the responsibility that is an integral part of this time. It is during this period that it is important to follow the basics of a healthy lifestyle, taking into account the requirements of pregnancy. Proper nutrition during pregnancy is the most relevant, since it is on what a woman eats that largely depends on how her child will develop. For example, whether a pregnant woman receives enough protein depends on whether the child will have enough building material. nine0005

It makes sense to take into account one important feature: proper nutrition in early pregnancy will be somewhat different from the diet of a pregnant woman in the last weeks.

Not everyone understands where such differences come from, but understanding the topic will be quite simple. Judge for yourself, important systems of the body are laid in the early stages, but the size of the fetus increases slightly. Therefore, in the early stages healthy nutrition of pregnant women is based on sufficient intake of minerals, vitamins and the like. nine0005

In the second trimester of pregnancy, nutrition should focus on increased protein intake, since it is now that the active growth of the child and its internal organs begins. All this requires a building material, that is, protein.

Nutrition in the third trimester of pregnancy is, first of all, vitamins and minerals that are necessary for the development of the internal systems of the child's body, especially calcium for bone growth and the development of the nervous system. nine0005

When planning a pregnancy, proper nutrition is also very important. The more healthy, hardy, strong the woman's body at the time of conception, the greater the chance of successfully fixing the fetal egg in the uterus. And a certain set of vitamins in the body contributes to the proper development of the embryo.

As you can see, the difference in recommendations for proper nutrition of pregnant women by months, and sometimes even by weeks, is quite justified. However, there are, of course, general rules for proper nutrition during pregnancy, so they will be discussed further. nine0005

General principles of proper nutrition during pregnancy

First of all, it is worth remembering one simple thing: it is better to get up from the table slightly hungry than with a heaviness in the stomach from overeating. In this regard, it is better to adhere to the principles of fractional nutrition altogether: eat less, but more often. The ideal option would be to eat 5-6 times a day. The last meal should be 3 hours before bedtime. If the feeling of hunger is unbearable, you can drink a glass of milk or yogurt, eat an apple or a pear. It is this diet for pregnant women that will be most optimal. nine0005

Proper nutrition during pregnancy, like, in fact, any proper nutrition, involves the exclusion or maximum restriction of fried foods, pickled foods and smoked meats. Steamed, boiled, stewed or baked food will be much more useful. Food for pregnant women should be as fresh and natural as possible, should not contain preservatives, excess salt and the like.

Obviously, canned foods, various sausages and other long-term storage products, if they are not banned, then require strict control of their use. nine0005

Of course, it is recommended to give up fast food. However, it is worth noting that if there is a choice - to stay hungry or eat something not very healthy, it is still better to choose the latter. A pregnant woman should not starve. Another thing is, if you get suspiciously often before such a choice, then you should think about carrying fruit or sandwiches with you.

Of great importance is the balance between such important components of nutrition as proteins, fats, carbohydrates, as well as vitamins and minerals. Of course, a balanced diet for pregnant women at different times implies a different balance of these components, the fact itself remains unchanged. nine0005

Meals by week

1-3 weeks pregnant

Gynecologists count pregnancy not from the day of conception, since it is almost impossible to calculate it, but from the first day of the last menstruation. Therefore, the first 2 weeks of the obstetric gestation period falls on the time before conception.

Pregnancy planning is an extremely important period, on which, whatever one may say, both the health of the unborn child and the absence of any complications during pregnancy depend. So it turns out that proper nutrition before pregnancy is of paramount importance. At this stage, it is very important to increase the amount of folic acid. Often doctors recommend drinking it in capsule form, but it is much better to get all the vitamins from normal food. Folic acid is found in green leafy vegetables (spinach, lettuce, cabbage, etc.), asparagus, beans and legumes, seeds and nuts, citrus fruits. nine0005

It is equally useful to consume yellow fruits and vegetables. But it is better to refuse fatty and sweet foods. This will avoid problems with obesity, as well as reduce the risk of early toxicosis.

Approximately on the 10-14th day of the cycle, fertilization occurs and the movement of the fetal egg begins towards the uterus. From this time on, we can talk about the onset of pregnancy.

3 weeks

Nutrition at the beginning of pregnancy is a very complex topic, since literally every week new organs and systems appear in the fetus, which means that the need for vitamins and nutrients is constantly changing. nine0005

In the third week of pregnancy, the egg is implanted and the placenta begins to develop, as well as the fetal membrane. For their full development, calcium is needed, which is found in dairy products, nuts, fish, legumes, fruit juices and cereals; and manganese, it can be obtained from nuts, spinach, beets, mushrooms, animal liver.

4 weeks

For 4 weeks, the nutrition remains the same as for 3, but at this time it is especially important to give up coffee. However, drinking this, of course, tasty, but not very healthy drink during pregnancy is with extreme caution. Especially coffee is contraindicated in the evening. As you can see, proper nutrition in the first month of pregnancy is not too difficult. Further it will be a little more difficult. nine0005

Week 5

As a rule, at about this time, toxicosis of pregnant women begins. To alleviate this condition, you can slightly change your daily menu. So, meat and eggs, as well as other animal proteins, can be replaced with nuts, soy and other legumes. Instead of milk, you can eat yogurt and cheese. It will not be superfluous to introduce carrots, mangoes, apricots into the diet.

Week 6

Toxicosis is in full swing, so the morning should start with crackers or unsweetened crackers. It is better to eat them immediately after waking up, without getting out of bed. At this stage, it is better to drink plenty of fluids, at least 8 glasses a day (for example: water with lemon juice or tea with lemon). At night, you can eat a handful of raisins. nine0005

7 week

At this time, problems with the intestines may arise. Therefore, you should avoid foods that promote gas formation, including cabbage. It will not be superfluous to refuse those products that are attached. It is better to introduce prunes, fresh kefir and the like into the diet.

8 week

Ginger tea will help to cope with toxicosis, and do not forget about nuts.

nine0077 9-10 weeks

Opt for whole grain cereals and whole grain breads. Brown rice is better than white. In general, the body of a pregnant woman at this stage requires quite a lot of fiber.

11-12 weeks

The first trimester of pregnancy is coming to an end, and nutrition at this time should be special. This is the most difficult time, and it is very important to listen to yourself, to your body. If you want to eat a particular dish, then it is precisely those substances that are contained in it that your baby is lacking. Of course, you shouldn't go to extremes. nine0005

13-16 weeks

Nutrition in the 2nd trimester during pregnancy is characterized, as already mentioned, by abundant protein intake. In addition, it is necessary to increase the total daily caloric intake of food. If in the first trimester it will be enough to eat 2400-2700 kcal, then from now on you need to eat 2700-2900 kcal.

16-24 weeks

Nutrition at 6 months of pregnancy should contribute to the development of the child's vision and hearing. That is, you need vitamin A and beta-carotene. At this time, it is better to eat cabbage, yellow peppers, carrots. Keep in mind that vitamin A is absorbed only with fats. nine0005

24-28 weeks

It is at this time that fractional nutrition becomes especially relevant. The uterus is actively growing, taking up more and more space in the abdominal cavity, and begins to put pressure on the stomach. Accordingly, the stomach becomes smaller, and it is difficult for him to accommodate a large amount of food. Even when eating small meals, a pregnant woman may be bothered by heartburn. It is better to give up carbonated drinks and coffee, they also provoke heartburn. In general, the nutrition of a pregnant woman in the third trimester should be as diverse as possible, as the needs of the baby grow. nine0005

29-34 weeks

At 8 months, bones are actively growing and teeth are being laid, therefore, it is very important to eat as many calcium-containing foods as possible. For brain development, fatty acids are simply necessary, and it is they that contribute to the absorption of calcium. Iron deficiency at this time can lead to the development of anemia, both in the mother and in the child. Fatty fish, nuts, red meat, dark green vegetables and seeds are the foods to eat during this period of pregnancy. nine0005

35-40 weeks

Nutrition at the 9th, last month of pregnancy should contribute to the overall strengthening of the mother's body. After all, ahead of her is a very difficult and time-consuming work - childbirth. The main source of energy in the body are carbohydrates, and it is their consumption that should become the basis of the nutrition of a pregnant woman before childbirth. Porridges and vegetables are the foods that you should eat during this period.

That's all that can be said about trimester nutrition. An example of a menu for pregnant women in terms of trimesters may also not be superfluous. Based on these menus and their explanations, you can create a menu for yourself. nine0005

Sample menu for pregnant women for the 1st trimester

1. Breakfast: muesli with yogurt and freshly squeezed pear juice.
2. First snack: salmon sandwich.
3. Lunch: mushroom soup, coleslaw, herbal tea.
4. Second snack: whole grain bread with cheese.
5. Dinner: carrot salad and vegetable risotto. You can drink everything with kefir.

In the first trimester, it is very important that a woman receives a large amount of folate and vitamin B6 from food. nine0005

Sample menu for pregnant women for the 2nd trimester

In the second trimester for pregnant women, the presence of omega-3 acid, calcium, vitamin D and iron in the diet is important.

1. Breakfast: oatmeal with milk, apple and cinnamon, chamomile tea.
2. First snack: almonds with prunes.
3. Lunch: lentil soup, seaweed salad, cranberry juice.
4. Second snack: herring sandwich.
5. Dinner: omelet with mushrooms and yogurt. nine0246

Sample menu for pregnant women for the 3rd trimester

This is where carbohydrates and vitamin K play a special role.

1. Breakfast: pancakes with cream cheese and curdled milk.
2. First snack: whole grain cheese sandwich.
3. Lunch: fish hodgepodge, tuna and herb salad, rosehip broth.
4. Second snack: cheesecake.
5. Dinner: fish with rice and fermented baked milk.

Special nutrition for pregnant women

But this is not all the nutritional features of pregnant women. In some cases, women develop pathologies during pregnancy that require special nutrition. So, with anemia of pregnant women, special nutrition is simply necessary. A woman experiencing pregnancy anemia should consult a doctor not only about medication, but also about an appropriate diet. With such a disease, it is very important to increase the intake of foods containing iron. Iron can be obtained from animal products (lean red meat, fish, poultry) and vegetable (nuts, dried porcini mushrooms, spinach, buckwheat, legumes, etc.) origin. In addition, it is important not only to know which foods to use, but also in what combinations, as this affects the absorption of iron in the human body. Vitamin C increases the absorption of iron in the body, that is, the combination of products containing iron and vitamin C is favorable.

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