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Mayo Clinic Q&A: concern about another miscarriage; fermented foods

Published Sep. 1, 2016

MISCARRIAGE RAISES CONCERNS

Six months ago, after becoming pregnant for the first time, I had a miscarriage at 12 weeks. My husband and I want to become pregnant again, but we're worried about another miscarriage. Are there things I can do to prevent it? I'm 27 and don't have health problems.

Having a miscarriage can be shocking, stressful and sad. It's understandable that you want to do everything you can to avoid going through it again. In most cases, a miscarriage isn't related to anything a pregnant woman did or did not do. The majority of miscarriages are due to chromosomal abnormalities that happen for no clear reason.

In general, a miscarriage is defined as the loss of a pregnancy before 20 weeks gestation. Miscarriage tends to be more common than people might think. Doctors estimate that up to 25 percent of all recognized pregnancies end in miscarriage.

Most miscarriages happen because the fetus isn't developing normally. Problems with the baby's genes or chromosomes are usually the result of errors that occur by chance as the embryo divides and grows. They typically aren't due to an inherited disorder, and usually aren't caused by a mother's behavior or health.

That said, there are a few risk factors that can raise the chances of having a miscarriage. Among the most significant is advanced maternal age. Women older than 35 have a higher risk of miscarriage than do younger women. At 35, the risk of miscarriage is about 20 percent risk. At 40, it goes up to about 40 percent. At 45, it's about 80 percent.

Another risk factor is having certain medical conditions. Disorders that may raise the risk of a miscarriage include uncontrolled diabetes, high blood pressure and infections.

When it comes to lifestyle choices, it is important to avoid smoking, drinking alcohol or using illegal drugs when you are pregnant. These activities raise your risk for a miscarriage and endanger the health of your baby. If you are on prescription medication, ask your doctor if it's safe to continue taking it.

Staying at a healthy weight before you become pregnant and throughout your pregnancy may also help ensure your baby's health. Being underweight or overweight appears to be linked to an increased risk of miscarriage.

None of the following activities cause miscarriage: lifting, straining, having sex or exercising.

If you have questions or concerns about becoming pregnant again, talk to your health care provider.

If you become pregnant again, unless an underlying medical condition is identified that needs special care, you shouldn't need to do anything differently. Get regular prenatal care and focus on taking care of yourself and your baby.

Yvonne Butler Tobah, M.D., Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn.

FERMENTED FOOD FINDINGS

Are there any special health benefits to fermented foods?

The jury's still out. In recent years, claims of possible health benefits of fermented dairy or plant foods, such as yogurt, kefir, aged cheese, tempeh, miso, sauerkraut and many others, have gained the spotlight.

The digestive tract is loaded with beneficial bacteria. Likewise, live, active bacteria make fermented foods possible. These bacteria, known as probiotics, are where the potential health benefits in fermented food may be.

While it sounds promising, the evidence is more suggestive than proved. Some evidence supports select probiotic use for certain bowel disorders. Research is ongoing to understand how probiotics may influence other areas of health, including obesity and regulation of the immune system.

To gain benefits, it is generally thought that a daily probiotic dose of around 10 billion colony-forming units (CFU) of certain bacteria strains is needed. However, fermented foods are all over the map in terms of the dose and type of beneficial bacteria. Some fermented foods contain supplemental probiotics to achieve a consistently high dose. Others might contain only moderate or low levels of live cultures — or no live cultures at all.

Fermented foods can be a part of a healthy diet and may provide health benefits that other foods can't. But, it's hard to say exactly what you're getting from a fermented food in terms of bacterial type or dose. Therefore, it's difficult to know what you can expect in terms of probiotic benefits. In addition, a fermented product with live active cultures also may contain high levels of saturated fat, salt or added sugars.

John K. DiBaise, M.D., Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Ariz. (adapted from Mayo Clinic Health Letter)

Mayo Clinic Q & A is an educational resource and doesn't replace regular medical care. Email a question to MayoClinicQ&A@mayo.edu. For more information, visit mayoclinic.org. © 2016 Mayo Foundation for Medical Education and Research. Distributed by Tribune Content Agency LLC. All rights reserved.

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