Study Sheds Light on What Factors Lead to a Normal Pregnancy

Promoting health and wellness, including increasing fruit intake and receiving a steady paycheck, may help reduce pregnancy complications, according to a study published in BMJ.

Researchers from the United Kingdom, Ireland, and New Zealand reviewed 5628 healthy women with singleton births, and no prior pregnancies, to ascertain what factors were most likely to lead to a normal pregnancy. Although the researchers are clear to point out that more study is needed to determine a causal relationship, they say their work implies that targeted interventions that encourage women to make healthy choices before and during pregnancy could reduce complications and lead to normal pregnancy outcomes.

“We have always known that a mother's general health is important, but until now we did not know the specific factors that could be associated with a normal pregnancy,” said Dr. Lucy Chappell, lead author from the Division of Women's Health at King's College London, in a news release. “Although this is an early study, these findings suggest that by leading a healthy lifestyle both before and during pregnancy-including eating lots of fruit and maintaining a healthy BMI-it could be possible for women to increase the likelihood of experiencing an uncomplicated pregnancy.”

Of the 5628 women, 61% had an uncomplicated pregnancy. The most common reasons for a complicated pregnancy in the mother were gestational hypertension (8%) and pre-eclampsia (5%). The most common neonatal complications were small for gestational age (11%) and spontaneous preterm birth (4%).

The likelihood of an uncomplicated pregnancy appeared to increase among women with pre-pregnancy fruit intake of at least 3 times a day (relative risk, 1.09; 95% CI, 1.01 to 1.18) and being in paid employment at 15 weeks’ gestation (relative risk per 8 hours’ increase, 1.02; 95% CI, 1.01 to 1.04.)

Women who during the first trimester had increased body mass index and increased blood pressure or misuse of drugs-including binge drinking-were more likely to experience pregnancy complications.

The authors suggested that reducing just high blood pressure could raise the proportion of uncomplicated pregnancies by 3.1% but again noted that more extensive research is need to back up that claim.

Pertinent Points:
- Helping women to improve their wellness before and during pregnancy could reduce pregnancy complications.
- More research is needed to determine whether there is a causal relationship between health behaviors such as maintaining a healthy BMI and reducing pregnancy complications, the authors emphasized.

References:

Reference
Chappell LC, Seed PT, Myers J, et al. Exploration and confirmation of factors associated with uncomplicated pregnancy in nulliparous women: prospective cohort study. BMJ. 2013;347:f6398.