Carbs and excess amniotic fluid.

This month’s study is The impact of 'low sugar diet' on amniotic fluid index in patients with idiopathic polyhydramnios (Tamayev et al., 2024).

Polyhydramnios is a condition where the pregnant mother is carrying an excessive amount of amniotic fluid relative to the baby’s gestational age. It affects up to 2% of pregnancies and is diagnosed through an ultrasound which measures pockets of fluid around the baby. It might be diagnosed using 3 different criteria:

• Amniotic fluid index (AFI) above 25cm2 from adding up the 4 deepest pockets of fluid from the four quadrants of the uterus

• A single deepest pocket of fluid measuring 8cm2

• The largest two-diameter pocket of amniotic fluid above 50cm2

Further, polyhydramnios is divided into mild or severe. In this Danish study (Bundgaard et al., 2010), 2/3 cases were mild and 1/3 were severe, meaning the 2-pocket measurement was above 100cm2.

About 1/3 of pregnancies with polyhydramnios can be linked to multiple gestations, foetal anomalies, or gestational diabetes which is considered the leading cause. With the other 2/3’s there is no known cause or association. This is called “idiopathic”.

Pregnancies with polyhydramnios are more at risk for placental abruption, postpartum haemorrhage, low Apgar score, big baby, caesarean delivery, and congenital malformations.

Since gestational diabetes is the most common condition associated with polyhydramnios, our study for this month looked at the impact of a reduced-carbohydrate diet on women with idiopathic polyhydramnios (they didn’t know why it occurred), meaning the women did not have gestational diabetes.

Women with polyhydramnios were divided into 2 groups. The intervention group adopted a lower carbohydrate diet replacing simple sugars with more vegetables and fibre. The control group continued with a routinely recommended pregnancy diet.

Within 2 weeks, the intervention group:

• reduced their amniotic fluid index by 18.4% compared to 4.8% in the control group

• 6.7% decrease in neonatal weight at birth

• 68% fully resolved their polyhydramnios after 2 weeks seeing a reduction in fluid from 27cm2 at enrolment to 20cm2 (a decrease of 27.5% in AFI)

Even though these women were not diabetic, it seems that excessive carbohydrates were possibly responsible for the over-abundance of amniotic fluid.

Given we’ve had decades of government health agency food recommendations (i.e. ensuring lobbyists and industries were well supported at our expense), our collective health is not doing well.

In fact, back in 2018, it was found that only 12% of Americans were metabolically healthy (Araújo et al., 2018). I can’t imagine much has improved in the last 6 years since the world went into lockdown, jobs and business were lost, injections harmed, and relationships were broken.

A return to sensible nutrition is needed and it may include more attention to carbohydrate intake at various times in our lives.

For the most researched information Lily Nichol’s Real Food for Pregnancy is a must.