AVOIDING FOODBORNE & OTHER HAZARDS IN PREGNANCY

Pregnant women should take certain precautions in order to avoid exposure to contaminated food and other hazards in the environment. The risk of these dangers in the United States is quite small but, like traffic accidents, they will happen to someone. A few simple precautions can make it much less likely that you will be affected.

Listeria monocytogenes is a common culprit in foodborne illnesses. This bacteria is very common and can be found in the air, soil, and water. When it has an opportunity to multiply in food items and is then eaten, it can cause fever and other flu-like symptoms and in some cases severe illness and even death. In pregnant women it may cause miscarriage and stillbirth.

This microorganism grows particularly well in meats and cheeses and it is for this reason that the US Centers for Disease Control and Prevention recommends that pregnant women:

• Avoid soft cheeses such as brie, camembert, feta, queso fresco, queso blanco, bleu cheese, and bleu cheese-containing products such as certain salad dressings. Regular cheeses and cottage cheeses have not been associated with Listeria.
• Cook all meat, seafood and poultry thoroughly and reheat leftovers until they need to cool before eating. Listeria is easily killed by heat so anything that is cooked well, even if it contains the soft cheeses mentioned above, should be safe.
• Avoid meat and cheese products sold at the delicatessen (grocery stores or sandwich shops). The problem here is that the cutters could become contaminated.
• Avoid unpasteurized milk or juice products.

 MERCURY

Mercury is a toxic metal that can cause birth defects. As methyl mercury, it is found in virtually all seafood in very tiny amounts that are not dangerous. But it is often present in higher levels in larger, long-lived fish that feed on smaller fish. For this reason, the U.S. Food and Drug Administration recommends that pregnant women avoid eating shark, swordfish, king mackerel, and tilefish. Fish caught by family and friends may also have higher levels of methyl mercury. Fish of any kind should probably not be eaten by pregnant women more than once a week.

Salmonella and Shigella are bacteria that typically cause diarrhea and severe abdominal cramps, as well as high fever and other symptoms. Children and pregnant women can be affected more severely. These microorganisms are usually transmitted by contaminated food and water. In the United States, the major risks are raw meats, especially chicken, and unpasteurized fruit juices. Salmonella can also live on the skin of reptiles such as iguanas, snakes, turtles, and so on.

Pregnant women are advised to use gloves or good handwashing when handling raw chicken, to cook eggs and chicken thoroughly, and to avoid handling reptiles.

Toxoplasma gondii is a parasitic microorganism that can cause severe birth defects in the children of infected mothers. It mostly infects small rodents and their predators such as cats. The infection is transmitted through eggs in these animals' feces and can be transferred by flies to food. "Indoor cats" that eat only canned, frozen, or dried food are seldom infected.

About 20-25% of women of child-bearing age in the United States have already been exposed to Toxoplasma gondii. But, except in rare cases, this does not pose a risk to the fetus. In general, a mother must become infected during pregnancy for her fetus to be affected.

In order to reduce the risk of being exposed to this microorganism, pregnant women are advised to avoid direct contact with animal, and especially cat, feces. This means having another person change the cat litter box and avoiding direct contact with sandboxes or flowerbeds used by cats.