Food poisoning: Can it affect your baby-to-be?

A few weeks ago, in my fifteenth week of pregnancy, I became ill with vomiting and diarrhea. I am now afraid that I was exposed to E-coli or Salmonella. Could this affect my pregnancy?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

"Food poisoning" is a very generic word and unless we know the precise nature of the illness and the causative agent, it would be difficult to say if it would present a hazard to a pregnancy.

Some foodborne infections, such as those which might be encountered in restaurants or at home, result in mild gastrointestinal discomfort with no consequences for the mother or baby. Some, however, pose a significant threat depending upon the type of infection, the seriousness of the infection and the health of the mother.

In general, many of us are exposed to foodborne pathogens every day. Unless we are very young or old -- or our immunity is compromised -- we usually do fine. We may or may not experience the typical symptoms such as nausea, vomiting or diarrhea.

Some argue that pregnancy represents a compromise in immunity. Actually in some cases, immunity is heightened. But the pregnancy does involve another, usually more vulnerable, patient -- the fetus. Depending upon his or her reserves, antibody status, gestational age and preexisting uterine environment, the baby may be adequately or inadequately prepared to weather the insult. In general, if the mother weathers the illness with no ill effects, her fetus is in better position to do the same.

Two key elements are favorable in your case. It was fairly early in your pregnancy, but not during a period of rapid cell development and you have apparently suffered no ill effects. Since you did not have a significant illness yourself requiring hospitalization, and you did not miscarry, the insult was probably minor. You did not acquire an infection in the amniotic fluid and did not give birth through a birth canal that might have active infection with a pathogen. These factors are all in your favor.

The anaerobic bacterium Clostridium botulinum produces the most potent food-related toxin known to humans. Although the effects of botulinum toxin are well documented, little is known about the effects of the toxin on the developing fetus. I found reports of two cases of botulism during pregnancy, both occurring in the third trimester. In the first report, the pregnancy was complicated by partial placental separation and precipitous delivery at 34-weeks-gestation; the infant had no evidence of botulism. In the second report, the infant of a long-term heroin user was delivered by cesarean section at 34-weeks-gestation and required several weeks of intensive care.

Botulinum toxin is a large molecule and is unlikely to diffuse passively across the placental membrane; however, it is not known whether an active transport mechanism exists or whether the neuromuscular effects of the toxin on pregnant women could affect fetal well-being. In one case report of botulism during the second trimester of pregnancy, there was no evidence of either transport of toxin across the placental barrier or ill effects of maternal neuromuscular compromise on the fetus.

Clostridium perfringens is another type of foodborne infection and, depending upon when it occurs, can lead to miscarriage and systemic infection and massive vascular collapse.

In the March 1997 issue of the Journal of Infectious Diseases, they evaluated the relationship of vaginal E. coli colonization to birth weight and other perinatal complications. Vaginal E. coli colonization was more strongly associated with delivery at less than 34-weeks and with very low birth weight. Heavy growth of E. coli had a higher risk of very low birth weight than light growth. Researchers concluded that it may be important to screen and treat pregnant women for genital tract colonization with E. coli during prenatal care. You could ask your care provider to perform a vaginal culture for E.coli. E. coli is also the primary cause of kidney infections in non-pregnant patients accounting for about 70 to 90 percent of infections.

I would think this event would present no ill effects on the baby but of course your own care provider could provide the best screening and counsel. Your local public health department might also be a good resource for you.

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