According to the 2007 National Sleep Foundation’s Sleep in American Poll (which focused on women and sleep), pregnant women are less likely than women in gen- eral to get a good night’s sleep [44]. Pregnant women also reported more daytime sleepiness and more frequent napping than did women in general [44]. They reported that “having to go to the bathroom” was the most common factor that disturbed sleep [44].
Given the known, increased difficulties with sleep during pregnancy, pregnant women should do the following to improve sleep:
• Prioritize sleep and get 7–9 h per day [45]. If needed, scheduled naps in the early afternoon can be used to increase the total sleep time, as long as they do not interfere with sleep onset at night.
• While staying hydrated during the day, reduce fluid intake in the hours before bedtime to decrease the frequency of urination during the night.
• Maintain a healthy diet that is high in fiber and limits saturated fats and refined foods [11].
• Have an evaluation for OSA if pauses during breathing accompanies snoring during pregnancy.
• Be screened for iron or folate deficiency if RLS develops during pregnancy. Non- pharmacologic RLS treatments (noted previously) may be of benefit.
References
1. National Sleep Foundation. Sleep in America poll; sleep in the modern family. Arlington VA:
National Sleep Foundation; 2014. p. 2014.
2. Luyster FS, Strollo PJ, Zee PC, Walsh JK. Sleep: a health imperative. Sleep. 2012;35:727–34.
3. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine func- tion. Lancet. 1999;354:1435–9.
4. Patel SR, Hu FR. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008;16(3):643–53.
5. Spaeth AM, Dinges DF, Goel N. Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults. Sleep. 2013;36(7):981–90.
6. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1:e62.
7. Chaput JP, Despres JP, Bouchard C, Tremblay A. Short sleep duration is associated with reduced leptin levels and increased adiposity: results from the Quebec Family Study. Obesity.
2007;15:253–61.
8. Dashti HS, Scheer FA, Jacques PF, Lamon-Fava S, Ordovas JM. Short sleep duration and dietary intake: epidemiologic evidence, mechanism, and health implications. Adv Nutr.
2015;6(6):648–59.
9. Lee KA, Gay CL. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol. 2004;191(6):2041.
10. Zafarghandi N, Hadavand S, Davati A, Mohseni SM, Kimiaiimoghadam F, Torkestani F. The effects of sleep quality and duration in late pregnancy on labor and fetal outcome. J Matern Fetal Neonatal Med. 2012;25:535–7.
11. St-Onge MP, Roberts A, Shechter A, Choudhury AR. Fiber and saturated fat are associated with sleep arousals and slow wave sleep. J Clin Sleep Med. 2016;12(1):19–24.
12. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed.
Darien, IL: American Academy of Sleep Medicine; 2014.
13. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.
14. Antony KM, Agrawal A, Arndt ME, Murphy AM, Alapat PM, Guntupalli KK, Aagaard KM. Obstructive sleep apnea in pregnancy: reliability of prevalence and prediction estimates.
J Perinatol. 2014;34(8):587–93.
15. Bassam H, Uliel-Sibony S, Katsav S, Farber M, Tauman R. Maternal sleep disordered breath- ing and neonatal outcome. Isr Med Assoc J. 2016;18(1):45–8.
16. Leung PL, Hui DSC, Leung TN, Yuen PM, Lau TK. Sleep disturbances in Chinese pregnant women. BJOG. 2005;112:1568–71.
17. Pien GW, Schwab RJ. Sleep disorders during pregnancy. Sleep. 2004;27(7):1405–17.
18. Pilkington S, Carli F, Dakin MD, Romney M, DeWitt KA, Dore CJ, et al. Increase in Mallampati score during pregnancy. Br J Anaesth. 1995;74:638–42.
19. Izci B, Vennelle M, Liston WA, Dundas KC, Calder AA, Douglas NJ. Sleep-disordered breath- ing and upper airway size in pregnancy and post-partum. Eur Respir J. 2006;27(2):321–7.
20. Bende M, Gredmark T. Nasal stuffiness during pregnancy. Laryngoscope. 1999;54:865–71.
21. Xu T, Feng Y, Peng H, Guo D, Li T. Obstructive sleep apnea and the risk of perinatal outcomes:
a meta-analysis of cohort studies. Sci Rep. 2014;4:69–82.
22. Ravishankar S, Bourjeily G, Lambert-Messerlian G, He M, De Paepe ME, Gundogan F. Evidence of placental hypoxia in maternal sleep disordered breathing. Pediatr Dev Pathol.
2015;18(5):380–6.
23. Whitehead C, Tong S, Wilson D, Howard M, Walker SP. Treatment of early-onset preeclamp- sia with continuous positive airway pressure. Obstet Gynecol. 2015;125(5):1106–9.
24. Guilleminault C, Palombini L, Poyares D, Takaoka S, Huynh NT, El-Sayed Y. Pre-eclampsia and nasal CPAP: part 1. Early intervention with nasal CPAP in pregnant women with risk fac- tors for pre-eclampsia: preliminary findings. Sleep Med. 2007;9(1):9–14.
25. Poyares D, Guilleminault C, Hachul H, Fujita L, Takaoka S, Tufik S, et al. Pre-eclampsia and nasal CPAP: part 2. Hypertension during pregnancy, chronic snoring, and early nasal CPAP intervention. Sleep Med. 2007;9(1):15–21.
26. Allen RP, Ricchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisir J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. Sleep Med.
2003;4:101–19.
27. Neyal A, Senel GB, Aslan R, Nalbantoglu M, Acikgoz S, Yilmaz N, et al. A prospective study of Willis-Ekbom disease/restless legs syndrome during and after pregnancy. Sleep Med.
2015;16(9):1036–40.
28. Prosperetti C, Manconi M. Restless legs syndrome/Willis-Ekbom disease and pregnancy.
Sleep Med Clin. 2015;10(3):323–9.
29. Picchietti DL, Hensley JG, Bainbridge JL, Lee KA, Manconi M, McGregor JA, et al. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis- Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2015;22:64–77.
30. Innes KE, Kandati S, Flack KL, Agarwal P, Selfe TK. The relationship of restless legs syn- drome to history of pregnancy-induced hypertension. J Women’s Health. 2016;25(4):397–408.
31. Oyieng’o DO, Kirwa K, Tong I, Martin S, Antonio Rojas-Suarez J, Bourjeily G. Restless legs symptoms and pregnancy and neonatal outcomes. Clin Ther. 2016;38(2):256–64.
32. Ramirez JO, Cabrera SA, Hidalgo H, Cabrera SG, Linnebank M, Bassetti CL, et al. Is pre- eclampsia associated with restless legs syndrome? Sleep Med. 2013;14(9):894–6.
33. Wesström J, Skalkidou A, Manconi M, Fulda S, Sundström-Poromaa I. Pre-pregnancy restless legs syndrome (Willis-Ekbom disease) is associated with perinatal depression. J Clin Sleep Med. 2014;10(5):527–33.
34. Weinstock LB, Walters AS, Paueksakon P. Restless legs syndrome--theoretical roles of inflam- matory and immune mechanisms. Sleep Med Rev. 2012;16(4):341–54.
35. Allen RP, Earley CJ. The role of iron in restless legs syndrome. Mov Disord. 2007;22:S440–8.
36. Soto-Insuga V, Calleja ML, Prados M, Castaño C, Losada R, Ruiz-Falcó ML. Utilidad del hierro em el tratamiento del trastorno por déficit de atención e hiperactividad. Anales de Pediatría [Spanish]. 2013;79:230–5.
37. Gupta R, Dhyani M, Kendzerska T, Pandi-Perumal SR, BaHammam AS, Srivanitchapoom P, et al. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mecha- nisms and treatment. Acta Neurol Scand. 2016;133(5):320–9.
38. Balaban H, Yildiz OK, Cil G, Senturk IA, Erselcan T, Bolayir E, et al. Serum 25- hydroxyvitamin D levels in restless legs syndrome patients. Sleep Med. 2012;13(7):953–7.
39. Oran M, Unsal C, Albayrak Y, Tulubas F, Oguz K, Avci O, et al. Possible association between vitamin D deficiency and restless legs syndrome. Neuropsychiatr Dis Treat. 2014;10:953–8.
40. Bayard M, Avonda T, Wadzinski J. Restless legs syndrome. Am Fam Physician.
2008;78(2):235–40.
41. Garcia-Borreguero D, Stillman P, Benes H, Buschmann H, Chaudhuri KR, Gonzalez Rodriguez VM, et al. Algorithms for the diagnosis and treatment of restless legs syndrome in primary care. BMC Neurol. 2011;11:28.
42. Neau JP, Marion P, Mathis S, Julian A, Godeneche G, Larrieu D, et al. Restless legs syn- drome and pregnancy: follow-up of pregnant women before and after delivery. Eur Neurol.
2010;64(6):361–6.
43. Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Mollica G, et al. Pregnancy as a risk factor for restless legs syndrome. Sleep Med. 2004;5(3):305–8.
44. National Sleep Foundation. Sleep in America poll; women and sleep. Washington, DC:
National Sleep Foundation; 2007. p. 2007.
45. Hirshkowitz M, Whiton K, et al. National Sleep Foundation’s sleep time duration recommen- dations: methodology and results summary. Sleep Health. 2015;1(1):40–3.
117
© Springer International Publishing AG, part of Springer Nature 2018 C. J. Lammi-Keefe et al. (eds.), Handbook of Nutrition and Pregnancy, Nutrition and Health, https://doi.org/10.1007/978-3-319-90988-2_7
Pregnancy Outcomes
Achyut Adhikari and Karuna Kharel
Keywords High risk foods · Listeriosis · Salmonellosis · Safe food handling Food-borne illness · Food safety during pregnancy
Key Points
• Hormonal changes during pregnancy compromises the immune system of preg- nant women making them prone to food-borne illnesses
• Listeriosis and toxoplasmosis are the two major food-borne hazards due to unsafe food handling practices that affect pregnant women
• Cross-contamination during handling of food is found to be one of the major causes of foodborne illness
• Cross-contact needs to be minimized for preventing food safety risk associated with allergens
• The basic principles of safe food handling at the preparation area include “Clean,”
“Separate,” “Cook,” and “Chill” that minimize the risk of illness
• Proper care should be given while handling foods at grocery stores to prevent the contact of high risk foods with the fresh produce
• Women are more receptive to food safety education during pregnancy, thus health care professionals need to consider disseminating the knowledge as much as possible for successful pregnancy outcomes
A. Adhikari (*) · K. Kharel
School of Nutrition and Food Sciences, Louisiana State University, Baton Rouge, LA, USA e-mail: [email protected]; [email protected]
Introduction
Food-borne illness or food poisoning is a sickness that occurs when harmful micro- organisms (bacteria, parasites, viruses) or chemical contaminants from foods or drinking water are ingested [1]. The US Centers for Disease Control and Prevention (CDC) estimates that each year, roughly 1 in 6 Americans (or 48 million people) get sick, 128,000 are hospitalized, and 3000 die of foodborne diseases [2]. Certain groups, such as pregnant women and their fetuses, young children, older adults, people with weakened immune systems, and individuals with certain chronic ill- nesses, are at higher risk of food-borne illness than others [3, 4]. This group of vul- nerable individuals makes up approximately 20% of the American population [4].
Pregnant women are at higher risk of food-borne illness because of hormonal changes that compromise their immune system. During pregnancy, pathogenic microorganisms can cross the placenta, infecting the fetus, whose immune system has not developed enough for self-protection. These infestations can cause miscar- riage, premature delivery, hearing loss, intellectual disabilities, blindness, or serious sickness [5, 6]. Thus, safe food handling during pregnancy is critical for the health of the mother-to-be and her baby.