Welcome to the weekly ZIP - your Zenith Informed Pregnancy!
Read on for a quick zip through 3 of the week’s most popular pregnancy questions, and the evidence behind them. Plus - bonus content on the latest & greatest in the world of pregnancy research.
This week's top pregnancy questions:
1️⃣ What cold & cough medicines are okay?
2️⃣ Should I get a flu shot?
3️⃣ Why do I keep getting charlie horse cramps?
What cold & cough medicines are okay during pregnancy?
Fall and back-to-school season are here, bringing up lots of questions about safe cold and cough remedies when opening up the medicine cabinet. The good news? There's solid research on many common over-the-counter ingredients.
📚The tl;dr from the evidence: Many cold and cough medicines are generally considered to be safe, especially with just short-term use during the second and third trimesters.
Safety research typically focuses on individual active ingredients, so always check what's actually in your medicine. For example, dextromethorphan, a common cough suppressant (found in Robitussin DM and Delsym), hasn't been shown to increase birth defect risk in multiple human studies.
More risk is introduced with combination medicines that target multiple symptoms. These expose you to more active ingredients than you might need, which can introduce unnecessary risks.
👀Read Penny’s full summary of the evidence for more on cough & cold meds
Should I get a flu shot?
Vaccines are top of mind for many as we enter the fall months where viruses become more prevalent – and especially so this year, with shakeups at the CDC making headlines and some states even committing to creating their own guidance on vaccination.
📚The tl;dr from the evidence: The flu vaccine is widely recommended by major health organizations like ACOG and the CDC. Pregnant people are advised to get the flu shot (but not the nasal spray version of the vaccine, which isn't recommended during pregnancy).
Getting the flu during pregnancy is riskier than usual. You're more likely to get seriously ill, need hospitalization, and face pregnancy complications like preterm birth.
The flu vaccine has strong evidence supporting its safety and efficacy in pregnant populations - large studies and ongoing monitoring of millions of pregnant people over many years have not found increased risks of miscarriage, birth defects, or other pregnancy complications.
👀Read Penny’s full summary of the evidence for more on influenza vaccination
Why do I keep getting charlie horse cramps?
If you're in the later months of pregnancy, you're not alone – leg cramps affect about 40-50% of pregnant people. With September being a peak birth month in the US (fun fact: 9 of the 10 most common birthdays happen in September!), lots of moms are dealing with this uncomfortable surprise right now.
📚The tl;dr from the evidence: The exact cause of pregnancy-related leg cramps isn’t fully understood, but there are a few factors that seem likely to play a role. Pregnancy leads to circulation changes, electrolyte shifts, muscle fatigue and weight gain, all of which can affect cramping.
The good news - while unpleasant, leg cramps are a common and normal symptom, and things like staying hydrated and gentle stretches can help alleviate the discomfort.
👀Read Penny’s full summary of the evidence for more on leg cramping symptoms
🤓 Zenith's top read of the week
Bonus: what the Zenith team found interesting this week. Think cool pregnancy research or recently published studies, news in pregnancy health and policy, and more!
Randomized controlled trials should include pregnant women (Alyssa Bilinski, STAT First Opinion) - a great opinion piece exploring the ethical concerns of not including pregnant women in clinical trials.
We’re excited to see the perspective arguing for more creative thinking on how we can ethically study the effects of novel therapies and medicines in pregnancy, considering both harms of using potentially unsafe, untested medicines in pregnancy, as well as potential under-utilization of safe and effective medicines due to lack of trials proving positive outcomes.
Key excerpt:
“More than 90 million women in the U.S. have given birth at least once. Still, pregnant participants are routinely excluded from clinical drug trials testing the safety and efficacy of medications. Excluding pregnant participants from RCTs is intended to prevent harm to them and their children. But it may, in fact, achieve the opposite: This practice exposes more people to potentially bad outcomes from untested medications and simultaneously allows fewer people to access the benefits of medical advances.”