Holiday foodborne illnesses and pregnancy: What ob-gyns should remind patients

Foodborne illness remains a clinically relevant concern during pregnancy, particularly surrounding holidays, such as Thanksgiving, when food preparation, storage, and large gatherings increase the likelihood of contamination. Pregnant individuals experience immunologic changes that elevate susceptibility to pathogens such as Listeria monocytogenes, Salmonella, Campylobacter, and Escherichia coli. These infections can lead to severe maternal complications as well as fetal morbidity and mortality. Counseling patients on practical, evidence-based food safety measures is an important aspect of prenatal care during the holiday season.

What foods pose the highest risk during Thanksgiving?

Several traditional Thanksgiving dishes present a greater risk for contamination when improperly handled. Undercooked poultry is a primary source of Salmonella and Campylobacter. Clinicians should remind patients that turkey must be cooked to an internal temperature of 165 °F (74 °C), including the stuffing if prepared inside the bird.¹ Cold dishes such as deli meats, soft cheeses made from unpasteurized milk, pâtés, smoked seafood, and refrigerated precooked meats increase the risk of Listeria exposure.¹ Leftovers that have been left at room temperature for extended periods — which is common at large holiday gatherings — can also support rapid bacterial growth.²

Patients should be advised to avoid raw cookie dough or batter containing eggs and flour, given the risk of Salmonella and E coli contamination.¹ Unwashed fruits and vegetables, especially those used in salads or garnishes, may also carry pathogens if not thoroughly rinsed.¹

Key counseling points for pregnant patients

Prenatal counseling should emphasize practical behavioral strategies that patients can easily implement during holiday events. Ob-gyns should encourage patients to inquire about how foods were prepared if they are eating at another person’s home. Patients can decline high-risk foods without stigma by preparing or bringing their own safe alternatives.

Hand hygiene before cooking and before eating remains essential. Cutting boards, utensils, and countertops used for raw poultry should be kept separate from those used for produce or ready-to-eat foods. Patients should also be reminded to refrigerate leftovers within 2 hours of serving, and leftovers should be consumed within 3 to 4 days or frozen promptly.²

Alcohol-containing dishes may retain alcohol, but patients should continue to avoid alcohol consumption itself, even in small amounts, consistent with current guidelines. (Note: While this is part of standard prenatal guidance rather than specific to food-borne illnesses, it is relevant in the holiday context.) Eggnog should be pasteurized and free of alcohol.

When should ob-gyns consider diagnostic testing?

Clinicians should counsel pregnant patients on symptoms that warrant evaluation. Fever, severe gastrointestinal symptoms, dehydration, and decreased fetal movement should prompt early clinical assessment. Listeria infection may present with nonspecific symptoms such as fever, myalgias, and malaise; therefore, heightened clinical suspicion is appropriate during and after the holiday season.³ Blood cultures are recommended when Listeria infection is suspected, even if gastrointestinal symptoms are mild or absent.⁴

The role of anticipatory guidance

Brief counseling during routine prenatal visits can meaningfully reduce risk. Pregnant patients frequently seek guidance on what they can safely consume during holidays, and proactive discussion can prevent confusion or misinformation. Clear, simple reminders—such as avoiding undercooked turkey, ensuring leftovers are refrigerated promptly, and steering clear of unpasteurized or raw foods—support maternal and fetal safety.

For ob-gyns, reinforcing these messages during the holiday season helps minimize preventable infections and supports evidence-based, patient-centered prenatal care.

References

1. Centers for Disease Control and Prevention. Food Safety for Pregnant Women. Accessed November 2025. https://www.cdc.gov/food-safety/foods/pregnant-women.html
2. US Food and Drug Administration. Food Safety for Pregnant Women. FDA; 2008. Accessed November 2025. https://www.fda.gov/media/83740/download
3. Mayo Clinic. Listeria Infection (Listeriosis): Symptoms and Causes. Accessed November 2025. https://www.mayoclinic.org/diseases-conditions/listeria-infection/symptoms-causes/syc-20355269
4. American College of Obstetricians and Gynecologists. Management of Pregnant Women With Presumptive Exposure to Listeria monocytogenes (Committee Opinion No. 614). Published December 2014. Accessed November 2025. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/12/management-of-pregnant-women-with-presumptive-exposure-to-listeria-monocytogenes