The Problem with Fruits, Vegetables, and Pregnancy

Between 2009 and 2013, there were 5.96 deaths for every 1,000 live births in the U.S. That works out to 107,462.26872 of the 18,030,582 deliveries analyzed in a 2017 report in the Annals of Epidemiology There are a variety of causes for these stillbirths, but a new report suggests that one cause may be the fruits and vegetables eaten by expectant mothers.

This new research was published at the end of October 2017 in JAMA Internal Medicine. It studied the relationship between insecticides found on fruits and vegetables and fetal mortality, since produce is believed to be the primary means by which insecticides enter the human body. What they found was that fruits and vegetables carrying higher levels of these chemicals did indeed decrease the odds of a live birth. Though the levels of pesticide on the produce was legal as determined by the US Environmental Protection Agency, “there has been a growing concern that permitted levels of pesticide residues in food defined by traditional toxicological testing may be too high, especially for susceptible populations such as pregnant women or infants,” according to the report.

Not all fruits and vegetables are created equal, of course. The study broke them down into two categories: high-residue, conventionally grown produce, and low-residue organic produce. It’s telling that consumption of the organic produce did not adversely affect the likelihood of a successful pregnancy and delivery.

Specifically, the researchers were looking to see if ingestion of high-pesticide fruits and vegetables correlated to less successful completion of infertility treatments with assisted reproductive technologies (ART). The subjects of the study were 325 women with an average age of 35.1, plus or minus four years, who self-reported their daily intake of fruits and vegetables before the beginning of ART. They had all enrolled in a study that began in 2006 — the Environment and Reproductive Health (EARTH) Study — at Massachusetts General Hospital Fertility Center in Boston.

Participants were categorized as conventional fruit and vegetable consumers if they ate organic produce less than three times a week, and organic consumers for consuming more than three.

The study found that when the women consuming organic produce were compared to those eating conventionally grown produce, the latter had between a 5% and 30% (with and average of 18%) lower chance of a clinical pregnancy, and an average 26% lower likelihood of a live birth as well, within a range of 13% to 37%.

Encouragingly, the research suggests that switching to a diet of organic fruits can increase positive outcomes, for all of the phases in ART, as well as live births.

The researchers offer several limitations inherent in the study. First of all, the intake of fruits and vegetables was self-reported by participants, without any verification of internal insecticide levels via physical examination. Second, the direct linkage between individual insecticides and specific pregnancy and birth outcomes has not been concretely established. Another factor is that all subjects were patients of a fertility clinic, so it’s not clear if their results would track with a more generalized population.

Still, the report offers reinforces the importance of choosing the right foods — and from the right sources — carefully, especially if a pregnancy is planned or underway.