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From The Nutritional Health Bible by Linda Lazarides (1997). This free database is provided for interest only. Linda's later writings refer to more up-to-date research.

• Moderate and high alcohol consumption
• Nutritional deficiencies, especially zinc, magnesium, calcium, selenium, folic acid
• Smoking

On the basis of low serum, hair and white blood cell levels, it would appear that at least 5 mg per day of additional zinc is required in pregnancy, which is not covered by the diet or available from material reserves. The risk of deficiency is real, and is associated with miscarriage, toxaemia of pregnancy, treatment-resistant anaemia, abnormally prolonged pregnancy and difficult delivery. In babies it is associated with decreased immunity, learning or memory disorders or birth defects. Favier A et al: Effects of zinc deficiency in pregnancy on the mother and the newborn. Rev Fe Gynecol Obstet 85(1):13-27, 1990.

High-dosage iron and folic acid supplements prescribed by doctors for pregnant women can seriously lower zinc levels or inhibit zinc absorption. Am J Clin Nutr 43:258-62, 1986.

Serum selenium levels were measured in women who had miscarried, and compared with pregnant women and healthy volunteers. Although it is usual for selenium levels to decline in pregnancy, those who had miscarried had significantly lower selenium levels than normal. The authors recommend that research to assess the benefits of selenium supplementation should be carried out. Barrington JW et al: Selenium deficiency and miscarriage: a possible link? Br J Obstet Gynaecol 103(2):130-2, 1996.

Cigarette-smoking habits were compared in 574 women who had suffered miscarriages, and 320 control women who had carried a baby to term. Women who had miscarried tended to smoke more often than controls. Smoking mothers had an 80 per cent higher risk of miscarriage than non-smoking mothers. Kline J et al: Smoking: a risk factor for spontaneous aboartion. N Engl J Med 297(15):793-6, 1977.

Alcohol and smoking habits were recorded in 32,019 women at their first visit to an ante-natal clinic and compared with rates of miscarriage. Women consuming 1-2 alcoholic drinks daily were twice as likely as non-drinkers to miscarry in the second trimester of pregnancy (15-27 weeks), and women consuming more than three drinks daily had more than three times the risk of miscarriage. Harlap S et al: Alcohol, smoking, and incidence of spontaneous abortions in the first and second trimester. Lancet 2(8187):173-6, 1980.

A meta-analysis was carried out on trials using calcium supplements to treat pre-eclampsia (a condition involving high blood pressure in pregnancy). The pooled analysis showed a significant reduction in systolic and diastolic blood pressure. Compared with placebo, calcium supplementation reduced the risk of pre-eclampsia by more than 60 per cent. Bucher HC et al: Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized controlled trials. JAMA 275(14):1113-7, 1996.

Eclampsia, in which high blood pressure is associated with convulsions in pregnancy and can lead to death, may be treated with magnesium, the tranquillizer diazepam or the anti-convulsant drug phenytoin. Outcomes of these three treatments were compared in 1,687 randomized women. Women allocated magnesium treatment had a 52 per cent lower rate of recurrent convulsions than those allocated diazepam and a 67 per cent lower risk compared with phenytoin. Women allocated magnesium treatment were also less likely to develop complications and to be admitted to intensive care, as were their babies. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 345(8969):1455-63, 1995.

In 27 pregnant women with pregnancy-induced high blood pressure, supplemented with magnesium, there was a significant reduction in mean blood pressure. The babies born to the magnesium-treated group spent fewer days in the neonatal intensive care unit. Rudnicki M et al: The effect of magnesium on maternal blood pressure in pregnancy-induced hypertension. A randomized double-blind placebo-controlled trial. Acta Obstet Gynecol Scand 70(6):445-50, 1991.