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It absolutely makes sense that a good diet before and during pregnancy is associated with better pregnancy outcomes, including the risk for miscarriage.

Researchers at the University of Birmingham reviewed 20 studies (for a total of 63,838 women) and found that a good diet with healthy foods (both preconception and during pregnancy) is linked to a lower chance of miscarriage. On the other hand, a diet high in processed foods was associated with a doubling of miscarriage risk. Interestingly, higher intake of fried foods and a lower intake of chocolate is also associated with higher miscarriage odds.

What is a "good diet" linked to lower risk of miscarriage? One that is rich in fruits, vegetables, dairy, eggs, and seafood. A high intake of fruits was linked to 61% reduction of miscarriage risk, high intake of vegetables had a 41% reduction, dairy was linked to a 37% reduction, and consumption of eggs had a 19% reduction. Seafood (fish) had a 19% reduction.

Hmmm.... overall the results sound like Mediterranean-style or healthy Nordic foods diets are beneficial. By the way, the researchers were unable to draw any conclusions regarding meat, red meat, white meat, fat, and oil.

There are many reasons for the lower rate of miscarriage with a healthy, whole foods diet: from an increased intake of all sorts of nutrients (vitamins, minerals, flavanols, etc.), rich in anti-oxidants, less oxidative stress, lower rates of inflammation, boosts the immune system, to feeding beneficial microbes in our gut microbiome.

Fun fact: the developing fetus can taste the foods the mother eats.

From Medical Xpress: Diet high in fruit and vegetables linked to lower miscarriage risk

A preconception and early-pregnancy diet that contains lots of fruit, vegetables, seafood, dairy, eggs and grain may be associated with reducing risk of miscarriage, a new review of research suggests. ...continue reading "A Good Diet Is Associated With Lower Rates Of Miscarriage"

Image result for pills wikipedia Sometimes there is a need to take antibiotics during pregnancy. A recent study of 182,369 pregnant women found that the use of certain antibiotics during early pregnancy was linked with a higher rate of miscarriage before 20 weeks. These antibiotics included quinolones (Avelox, Cipro, Levaquin, Tequin), tetracyclines, sulfonamides (Septra, Bactrim), metronidazole (Flagyl), and macrolides (such as azithromycin, clarithromycin, but not erythromycin).

Certain antibiotics were not associated with spontaneous abortions. These antibiotics were penicillins, cephalosporinsnitrofurantoin, and erythromycin. The researchers pointed out that nitrofurantoin is a good antibiotic option for urinary tract infections - which is one of the most common infections in pregnancy. From Medscape:

Antibiotics During Pregnancy May Increase Miscarriage Risk

Use of certain antibiotics early in pregnancy is associated with an increased risk for spontaneous abortion, the authors of a new study report. Macrolides (except erythromycin), quinolones, tetracyclines, sulfonamides, and metronidazole all were associated with a greater risk, compared with penicillins, cephalosporins, or no antibiotic exposure at all, Flory T. Muanda, MD, and colleagues write in an article published in the May 1 issue of CMAJ. 

To assess the potential effect of antibiotics on miscarriage risk, Dr Muanda, from the Faculty of Pharmacy, Université de Montréal, Quebec, Canada, and colleagues analyzed data from the Quebec Pregnancy Cohort on pregnancies that occurred between January 1998 and December 2009....Women who experienced a clinically detected spontaneous abortion before gestational week 20 were considered cases, with the calendar date of the spontaneous abortion designated the index date.  Antibiotic exposure was defined as "having filled at least 1 prescription for any type of antibiotic either between the first day of gestation and the index date, or before pregnancy but with a duration that overlapped the first day of gestation," the authors explain. 

Antibiotic exposure occurred in 12,446 (13%) of those pregnancies, including 1428 that ended in spontaneous abortion (16.4% of all pregnancies ending in spontaneous abortion). Among the control patients, 11,018 (12.6% of all controls) were exposed to antibiotics.

In some instances, these findings support data from other studies, the authors point out. The class effect observed of tetracyclines and quinolones "supports current guidelines used in obstetrics that do not recommend use of these drugs in early pregnancy." Their finding that metronidazole was associated with a 70% increase in the risk for spontaneous abortion is similar to that of a study among Medicaid patients showing a 67% increased risk.... No increased risk was associated with nitrofurantoin, erythromycin, penicillins, or cephalosporins.

Coffee consumption overall seems to be beneficial to health in various ways, such as lowering the risk of colorectal cancer. But there are times one should limit how much one drinks, such as during the  preconception period for both the male and female, and also during pregnancy, to lower the risk of miscarriage.

From Science Daily: Coffee consumption linked to decreased risk of colorectal cancer

Researchers have found that coffee consumption, including decaf, instant and espresso, decreases the risk of colorectal cancer. Moreover, these benefits increase the more coffee you drink. The study examined over 5,100 men and women who had been diagnosed with colorectal cancer within the past six months, along with an additional 4,000 men and women with no history of colorectal cancer to serve as a control group. Participants reported their daily consumption of boiled (espresso), instant, decaffeinated and filtered coffee, as well as their total consumption of other liquids.....

The data showed that even moderate coffee consumption, between one to two servings a day, was associated with a 26 percent reduction in the odds of developing colorectal cancer after adjusting for known risk factors. Moreover, the risk of developing colorectal cancer continued to decrease to up to 50 percent when participants drank more than 2.5 servings of coffee each day. The indication of decreased risk was seen across all types of coffee, both caffeinated and decaffeinated.

Coffee contains many elements that contribute to overall colorectal health and may explain the preventive properties. Caffeine and polyphenol can act as antioxidants, limiting the growth of potential colon cancer cells. Melanoidins generated during the roasting process have been hypothesized to encourage colon mobility. Diterpenes may prevent cancer by enhancing the body's defense against oxidative damage. "The levels of beneficial compounds per serving of coffee vary depending on the bean, roast and brewing method," said first author Stephanie Schmit, PhD, MPH. 

Colorectal cancer is the third most common cancer that is diagnosed in both men and women in the United States, with nearly five percent of men and just over four percent of women developing the disease over their lifetime. The American Cancer Society (ACS) estimates that in the United States, over 95,000 new cases of colon cancer and 39,000 new cases of rectal cancer will be diagnosed in this year alone.

Both males and females should limit coffee consumption in the preconception period to no more than 2 caffeinated drinks daily to lower the female's risk of miscarriage. From Medscape:

Even Men Need to Cut Back on Coffee Before Pregnancy

Women already know they need to cut back on coffee during pregnancy, if not sooner, to lower the risk of miscarriage. But a new study suggests the men in their lives need to limit caffeine too. Pregnant women who had more than two caffeinated drinks a day while trying to conceive had a 74% higher risk of miscarriage than their peers who drank less coffee, tea, soda and energy drinks, the study found.

When their husbands and boyfriends had more than two caffeinated drinks a day during the preconception phase, however, these pregnant women ended up with almost the same increased risk of miscarriage they would get from drinking coffee or soda themselves...."We did not find drinking one to two daily caffeinated beverages to increase the risk of miscarriage." Scientists aren't sure how caffeine contributes to miscarriage, but it's possible it affects egg or sperm production, implantation of the fertilized egg, or the ability of the embryo to grow in the uterus.

To assess how lifestyle choices may influence miscarriage risk, Louis and colleagues followed 344 couples in Texas and Michigan through the first seven weeks of pregnancy....Overall, 98 women, or 28%, experienced a miscarriage during the study, as reported March 24 in the journal Fertility and Sterility. Women 35 or older had nearly double the miscarriage risk of younger women, the study found. When women took daily multivitamins, their miscarriage risk was 55% lower than for their peers who didn't do this.

One surprise in the study is that researchers didn't find an increased miscarriage risk associated with smoking or alcohol, however. This doesn't mesh with previous research, noted Dr. Jeffrey Goldberg, a reproductive health researcher at Cleveland Clinic in Ohio who wasn't involved in the study. 

The worrisome results are adding up for BPA and BPS. From Environmental Health News:

Miscarriage risk rises with BPA exposure, study finds

Women exposed to high levels of bisphenol A early in their pregnancy had an 83 percent greater risk of miscarriage than women with the lowest levels, according to new research. The scientists said their new study adds to evidence that low levels of the ubiquitous chemical, used to make polycarbonate plastic and found in some food cans and paper receipts, may affect human reproduction. The study involved 115 pregnant women who had visited a Stanford University fertility clinic within about four weeks of fertilization. The more BPA detected in the women’s blood, the higher their risk of miscarriage, according to the researchers.

“Couples suffering from infertility or recurrent miscarriages would be best advised to reduce BPA exposure because it has the potential to adversely affect fetal development,” wrote the scientists, led by Dr. Ruth Lathi, a Stanford University associate professor of obstetrics and gynecology. 

In 2005, a smaller study in Japan found that 45 women who had three or more first-trimester miscarriages had three times more BPA in their blood than 32 women with no history of pregnancy problems. 

From Science Daily:

BPA increases risk of cancer in human prostate tissue, study shows

Fetal exposure to a commonly used plasticizer found in products such as water bottles, soup can liners and paper receipts, can increase the risk for prostate cancer later in life, according to a study. Exposure of the fetus to BPA in utero is of particular concern, because the chemical, which mimics the hormone estrogen, has been linked to several kinds of cancer, including prostate cancer, in rodent models. The new findings show that human prostate tissue is also susceptible.

"Our research provides the first direct evidence that exposure to BPA during development, at the levels we see in our day-to-day lives, increases the risk for prostate cancer in human prostate tissue," Prins said

This study was done in rats, but thought to also apply to humans. From Science Daily:

Common BPA substitute, BPS, disrupts heart rhythms in females

Bisphenol S (BPS), a common substitute for bisphenol A (BPA) in consumer products, may have similar toxic effects on the heart as previously reported for BPA, a new study finds.

There is implied safety in BPA-free products. The thing is, the BPA analogs -- and BPS is one of them -- have not been tested for safety in humans." "Our findings call into question the safety of BPA-free products containing BPS," he said. "BPS and other BPA analogs need to be evaluated before further use by humans."