Pregnancy Journal (Deluxe, Cloth-bound edition): A Week-By-Week Guide to a Happy, Healthy Pregnancy

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For any substance, three or more of the following should have been present together at some time during the previous year. Advise her of the risks of smoking and of alcohol and cannabis use during pregnancy. The biggest risk for her pregnancy at present is her smoking. Strong evidence - one systematic review with ≥8 studies (group 1) or more than one systematic review (group 2); Yes. There are two vitamin supplements needed during pregnancy: folic acid and vitamin D . Those who follow a vegetarian/plant-based diet may need to take additional supplementation of iodine, omega-3 fatty acids and vitamin B 12 (see the BDA plant-based diet sheet). Delpisheh A, Brabin L, Brabin BJ. Pregnancy, smoking and birth outcomes. Women Health. 2006;2(3):389–403. https://doi.org/10.2217/17455057.2.3.389.

Huang HY, Chen HL, Feng LP. Maternal obesity and the risk of neural tube defects in offspring: A meta-analysis. Obes Res Clin Pract [Internet]. 2017 [cited 2021 Mar 12];11(2). Available from: https://pubmed.ncbi.nlm.nih.gov/27155922/ Bruin JE, Gerstein HC, Holloway AC. Long-term consequences of fetal and neonatal nicotine exposure: a critical review. Toxicol Sci. 2010;116(2):364–74. https://doi.org/10.1093/toxsci/kfq103. CDC. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs, United States. 2002.By concentrating on a healthy varied diet and staying active your body should naturally gain sufficient weight for your baby to be born at optimum birth weight. This is important for them to continue to grow and develop well.

Waylen AL, Metwally M, Jones GL, Wilkinson AJ, Ledger WL. Effects of cigarette smoking upon clinical outcomes of assisted reproduction: a meta-analysis. Hum Reprod Update. 2009;15(1):31–44. https://doi.org/10.1093/humupd/dmn046.

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Chilled food should be stored at the correct temperature (below 5°C). Foods should not be eaten after the ‘use by’ date. Wash soil from fruit, vegetables and salad. Alcohol in pregnancy To define light, moderate and heavy smokers, most studies [ 38, 39, 46, 62, 63, 64] chose smoking 10 cigarettes daily as a cut-off point to distinguish light smokers from moderate and heavy smokers. In some studies [ 4, 39, 46, 61, 64], both 10 cigarettes daily and 20 cigarettes daily were utilised as the thresholds. In one review the number of cigarettes consumed daily for each category was inconsistent [ 65]. All studies estimated the risk ratios compared to non-smokers [ 66], except for one review, in which light smokers were compared to moderate smokers. UK Department of Health. Drug misuse and dependence: UK guidelines on clinical management. 2017. https://www.gov.uk/government/publications/drug-misuse-and-dependence-uk-guidelines-on-clinical-management Pineles BL, Hsu S, Park E, Samet JM. Systematic review and Meta-analyses of perinatal death and maternal exposure to tobacco smoke during pregnancy. Am J Epidemiol. 2016;184(2):87–97. https://doi.org/10.1093/aje/kwv301. Food Standards Agency. Food Additives. 2018. Available from: https://www.food.gov.uk/safety-hygiene/food-additives#caffeine-in-energy-drinks-and-other-foods

Hollis BW. Vitamin D Requirement During Pregnancy and Lactation [Internet]. Vol. 22, Journal of Bone and Mineral Research. 2007. p. V39–44. Available from: http://dx.doi.org/10.1359/jbmr.07s215Weight loss is strictly not recommended during pregnancy as it can be harmful to the health of the growing baby. If you have a high BMI or are reducing your physical activity during pregnancy, your energy requirements may not change (see table above for a guide to weight gain and pregnancy). A dietitian would be able to guide you on avoiding excessive weight gain while ensuring you are eating well. Should I take additional nutritional supplements?