[A], Part 2

Pregnancy Do's and Don'ts: The Smart Woman's A-Z Pocket Companion for a Safe and Sound Pregnancy
by Elisabeth Aron, M.D.

(Page 2 of 2)

Air fresheners

Air fresheners and aerosol sprays are used to change the odor of the air.

Concerns: A recent study examining use of air fresheners and aerosols found an association between their use and an increase in ear infections and diarrhea in young exposed children and an increased risk for maternal depression. The researchers concluded that the cause may have been volatile organic compounds (VOCs). VOCs are a large, diverse group of organic chemicals that exist in a gas form at room temperature. VOCs are found in a variety of materials in the home, including aerosol sprays, new building materials (see Building materials), deodorants, and furniture polish (see Household cleaners). The majority of VOCs have not been reported to cause any harmful effects, but a few can cause headaches, dizziness, and worsening of respiratory diseases, such as asthma (see Asthma). Some VOCs have been recognized to be carcinogenic (cancer causing). The bottom line: Until more is known about the effects of these household air fresheners, it would be wise to avoid heavy use during pregnancy.

Air purifiers

Air purifiers remove allergens from the air using filters.

Concerns: Air purifiers have filters that work to trap particles, such as mold, dust, and pollen, that can cause allergies and asthma (see Asthma). When the filter needs to be changed and is not working optimally, these allergens can be released back into the air, causing an allergy or asthma flare-up. A simple way to avoid this is to keep up with the maintenance of your unit. Follow the manufacturer's suggestions for routine maintenance.

The bottom line: A well-maintained air purifier is safe in pregnancy.

Air travel

Air travel involves travel in airplanes.

Concerns: People have voiced many concerns and theoretical risks relating to flying during pregnancy, including increased risk of miscarriage; effects of pressure changes, dehydration, noise vibration, and radiation; and increased risk of blood clots at high altitudes.

• Risk of miscarriage: One study has shown that flight attendants do have a slightly increased risk of first-trimester miscarriages; however, some researchers now think that the high number of hours a week these women were flying and many other stresses contributed to their increased risk. Similar rates of miscarriage have not been seen in the casual flier.

• Altitude: Most commercial airlines keep the cabin pressurized to 5,000 to 8,000 feet (see High altitudes). Pregnancy at high altitude has been associated with low birth weight, preterm labor, and preeclampsia (hypertension, protein in the urine, and swelling). However, traveling at this altitude for a relatively short period of time does not appear to cause any pregnancy complications.

• Dehydration: Concerns over dehydration are based on an average cabin humidity of less than 25 percent, which is quite dry. However, keeping hydrated is not difficult, and this problem can be overcome.

• Blood clots: The theoretical concern that long periods of immobility may cause blood clots to form in the legs has not been substantiated by any published report to date, although much anecdotal evidence exists. Like dehydration, this concern can be easily addressed by moving about or stretching every couple of hours.

• Noise vibration and radiation: Studies have shown this is of negligible risk to travelers.

Commercial airlines often require documentation of your due date and may restrict your flight in the third trimester due to concerns that you may deliver in the air. Check with the airline before you make travel plans so you won't run into any unexpected problems. Finally, if you are having a high-risk pregnancy, consult with your health care provider before you travel. Consider taking a copy of your prenatal records with you in case you need emergency care while you are away from home.

The bottom line: Air travel is safe in pregnancy. Obviously, if a complication occurs when you are far from home, you may be forced to deal with new doctors. While traveling, make sure to keep well hydrated and stretch your legs every so often. Seat belt use is encouraged and considered to be safe.

Albuterol

Albuterol is a medication used in the treatment of asthma (see Asthma) and preterm labor.

Concerns: One study in laboratory mice reports an association between albuterol and an increased incidence of cleft palate. However, no published studies indicate an association between albuterol use and human birth defects. As a result, this drug has been assigned a pregnancy risk factor category of C (see Appendix 1). Albuterol can also cause hypotension (low blood pressure) and temporary increases in heart rate and so should be taken with care.

Women with well-controlled asthma have fewer pregnancy complications. In light of this, it seems prudent to take all prescribed asthma medications as directed to keep your asthma under good control. Albuterol may be part of this regimen.

The bottom line: Albuterol is safe in pregnancy.

Alcoholic beverages

Alcoholic beverages are made from a fermented mash of various ingredients, including grains or other plants. Popular types of alcohol include whiskey, gin, rum, vodka, wine, and beer.

Concerns:Alcohol is a known teratogen (cause of birth defects). Consumption of alcohol during pregnancy has been associated with intrauterine growth restriction (low birth weight), mental retardation, abnormal facial defects, and other major and minor fetal malformations. Although it appears that fetal alcohol syndrome (FAS) is caused by heavy drinking and/or binge drinking, currently there are no known safe levels of alcohol during pregnancy, and pregnant women are advised not to drink at all.

The bottom line: Although an occasional sip may be okay, there is absolutely no known amount of alcohol that is safe in pregnancy. Most health care providers recommend avoiding all alcohol during pregnancy.

Aleve®

Aleve® is a brand name of naproxen (see Naproxen; Pain relievers).

Allegra®

Allegra® is a brand name of fexofenadine (see Fexofenadine; Allergy medications).

Allerest®

Allerest® is a brand name of naphazoline (see Naphazoline; Allergy medications).

Allergy medications

Allergy medications are used to treat the symptoms caused by allergies, including nasal itching, runny nose, nasal congestion, watery eyes, and sneezing. Common brands include Allegra(r) (see Fexofenadine), Allerest® (see Naphazoline), Claritin® (see Loratadine), Nasacort® (see Triamcinolone acetonide), and Zyrtec® (see Cetrizine). Some are available over the counter while others require a prescription. These medications come in the form of pills, nasal sprays, and eye ointments.

Concerns: Most allergy medications have been assigned a risk factor category of B or C (see Appendix 1).

The bottom line: Most allergy medicines are considered to be safe in pregnancy. Discuss any specific allergy medications with your health care provider.

Alpha-lipoic acid

Alpha-lipoic acid (ALA) is a dietary supplement that has been used to treat many conditions, including diabetes, glaucoma, and alcoholic liver damage.

Concerns: Since ALA is categorized as a food supplement, it is not regulated by the U.S. Food and Drug Administration. Thus, there is no guarantee of the strength, purity, or safety of this product. Several studies have shown that ALA worked better than placebo in lowering blood sugar.

The bottom line: There is not enough known about the effect of ALA to recommend its use during pregnancy. Diabetes during pregnancy is a high-risk condition and should be treated by a physician with medications that are known to work.

Copyright © 2006 by Dr. Elisabeth Aron. Excerpted by permission of Broadway, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

Dr. Elisabeth Aron is an award-winning, board-certified specialist in obstetrics and a senior clinical instructor at the University of Colorado's Department of Obstetrics and Gynecology. She lives in Fort Collins, Colorado.