By Teresa Rubio Asensio BSc, MSc (embryologist).
Last Update: 09/08/2015

The mother’s pre-pregnancy health status, dietary habits and use of certain products such as tobacco or alcohol, pharmacologic treatments, and exposure to environmental toxicants on a daily basis or in the work place are very important factors which may influence the course of pregnancy and the baby’s health.

The different sections of this article have been assembled into the following table of contents.

Systemic diseases

Systemic diseases of the mother may affect the baby. To rule out the chances for a high-risk pregnancy, the mother-to-be has to follow a pre-conception care, especially in cases where there is any previous maternal disease.

There are certain external factors acting as teratogens, that is to say, increasing the chances for developing any congenital abnormality. Congenital abnormalities may be any anatomical, structural, functional, metabolic, or behavioral alterations which develop during any stage of embryogenesis. Thus, the baby might have them from birth.

Nutrient deficiencies

Insufficient intake of iodine and folic acid may cause the fetus to develop hypothyroidism or mental retardation, the latter in case there’s a lack in iodine supply. Insufficient levels of folic acid may lead to the development of spina bifida.

During early pregnancy, the neural tube, one of the most important structures of the fetus, starts its development. Taking supplements containing folic acid before and after early pregnancy may help preventing neural tube defects (e.g. anencephaly or spina bifida) as well as heart defects.

Calcium and phosphorus are equally important for the baby-to-be, since the bones and the teeth are developed from these elements. Pregnant women should ensure the sufficient intake of calcium to avoid bone decalcification to occur. In case you have lactose intolerance, eating non-dairy foods high in calcium such as soy derivates, small soft-boned fish, nuts, etc. is advisable.

Finally, monitoring your iron levels is very important as well, since the body needs to absorbe higher levels of iron during pregnancy. These increased levels are due to a higher volume in blood, the synthesis of fetal tissue, and the development of iron supplies in the fetus so that they can be used later while breastfeeding. Iron deficiency is related to iron-deficiency anemia in the baby during childhood.

Drugs and toxic products

Prenatal exposure to alcohol is one of the most common causes for mental retardation but also the most preventable. For this reason, all pregnant women are recommended not to drink alcohol during pregnancy and the breastfeeding period.

Effects of alcohol are known to be dose dependent, which means the higher intake, the greatest side effects for the baby. This is the reason why babies from alcohol-addicted women usually develop the most severe problems.

In addition to alcohol, abuse of tobacco, cocaine, inhalants, and any other synthetic drugs can lead to miscarriage, mental retardation, and congenital disorders.

Likewise, exposure to physical and chemical agents such as ionizing radiation, phytoestrogens, or organic solvents made of carbon like toluene, acetone, xylene, etc. may cause similar effects to alcohol or anesthesia.

Diseases of the mother and medicines

Misoprostol, anticonvulsants (a.k.a. antiepileptic drugs or AEDs), methotrexate (abbreviated MTX), retinoic acid, etc. may cause miscarriage, mental retardation, or birth defects, among others.

If the mother suffers from any disease such as epilepsy, she should ask her healthcare provider before getting pregnant in order to, as far as possible, have the medication substantially replaced by another one less toxic for the fetus and see if it also efficient for the mother.

Diabetes mellitus, hyperandrogenemia, or systemic lupus erythematosus are diseases which may affect fetal development as well by causing birth defects, sex reversal –in the case of hyperandrogenemia–, and heart block or transitional lupus.

Viral infections

There are also certain viral infections such as chickenpox and rubella that can be contracted by the mother and may have a negative effect on the fetus.

To rule out the chances for a high-risk pregnancy, there is a need to check if the mother has been immunized and, in case of doubt, vaccinating before pregnancy.

  • Rubella may cause the baby to develop Congenital Rubella Syndrome (CRS) during pregnancy. If the infection occurs during early pregnancy, in particular before week 16, it may cause severe effects in the fetus, such as blindness, deafness, mental retardation, or even heart defects.
  • Chickenpox may cause the fetus to develop Congenital Varicella Syndrome (CVS), especially before week 13, when there is a low risk of transmission (0.4%). However, between weeks 13 and 20, the risk increases up to 2% and may cause fetal malformations such as scarring of the skin, microcephaly, and problems with eyesight and hearing.

Previous exposure to toxoplasma, cytomegalovirus, herpes, syphilis, HIV, and hepatitis B or C should also be checked.

Numerous scientific studies have proved the beneficial effects of a healthy fetal development and how some factors impact on the individual’s lifetime. Among these benefits, we can find higher educational performance and behavioral levels among children, a higher health status during adolescence and adulthood, and lower rates of obesity, high blood pressure, or cardiovascular diseases.

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Authors and contributors

 Teresa Rubio Asensio
BSc, MSc
Embryologist
Master's Degree in Medicine and Reproductive Genetics from the Miguel Hernández University of Elche (UHM). Teacher of different Clinical Embryology courses at the UHM. Member and writer of scientific contents at ASEBIR and ASPROIN. Embryologist specializing in Assisted Procreation at UR Virgen de la Vega. More information
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2 comments

    1. roXy

      Okay, but as far as I know, coca-cola also contains a toxic substance called “caffeine”. Are you telling me I should quit cola? Sorry, I can’t. I drink like 3-4 colas a day on average. I’m planning to get pregnant but do you think this could be a problem for my baby? Give me an answer, please!

      • Sandra FernándezBA, MA

        Dear roXy,

        The answer is yes, caffeine may have an impact on fetal development. I recommend that you drink caffeine free coke during pregnancy as you will be able to keep drinking it but it won’t have an influence on your pregnancy.

        Cheers.