Ukubuyekezwa kwe-Perelel Prenatal Kuvusa Izingxoxo Phakathi Kobomama Abakhulelwe

Ukukhulelwa kumaka uhambo oluguqula kakhulu kubantu abaningi, olubandakanya izidingo ezihlukile emzimbeni, emizweni nasempilweni yokudla. Njengoba umzimba ushintsha ukuze wamukele umbungu okhulayo, ukubaluleka kokudla okunomsoco okulinganiselayo kuyaqina. Ochwepheshe bezempilo bavame ukuncoma izithasiselo zokukhulelwa ukuze baxazulule izikhala ezingaba khona ekudleni kwamavithamini, amaminerali nakwezinye izakhamzimba ezibalulekile. Eminyakeni edlule, omama abakhulelwe baye baba nokuzimisela okukhulu ukuphenya hhayi nje lokho abangakufaka emizimbeni yabo kuphela, kodwa futhi nokuthembeka nokuphepha kwale mikhiqizo. Umkhakha wezithasiselo usuguqukile kanjalo, izinkampani sezikhulisa imikhiqizo ehlelelwe izidingo zomzimba nezokuphila zomuntu ngamunye.

Lo msebenzi wokuguquka uveza isifiso kubantu abakhulelwe sokukuqonda kangcono isayensi esemva kwemikhiqizo yokukhulelwa. Nakuba iningi lamafomula e-prenatal lihlose ukusekela ukuthuthuka kombungu ngokusebenzisa uhlu olujwayelekile lwamavithamini namaminerali, inani elikhulayo labazali abazolayo manje lifuna izindlela eziningi ezibhekana nezinto ezifana nokushintsha kwamahomoni, amasosha omzimba, kanye nempilo yonke kamama. Njengoba intshisekelo kwezinhlanganisela ezicokeme kakhulu zokukhulelwa ikhula, izipiliyoni zabantu sezibe yisisekelo socwaningo. Omama abakhulelwe abasaxhomeki kuphela kudatha yezokwelapha; baphinde babheke imibono yabanye abasebenzisi, izinhlu zezithako ezinemininingwane, nezingxoxo eziqhubekayo emiphakathini egxile ekukhulelweni—okuhlanganisa nezibuyekezo ze-perelel prenatal. Lolu hlobo lwenkhulumo ngemikhiqizo namafomula amasha luyaqhubeka lwanda, lubonisa umkhuba obanzi wokufuna ukucaca nokuhlola ngokujulile ngaphambi kokuzibophezela komkhiqizo.

Ukulinganisa Isiko Nobuchwepheshe Ezinhlelweni Zokudla Ezihlanganisiwe

Ngokomlando, izithasiselo zabesifazane abakhulelwe zigxile ensimbini nase-folic acid ukuze kuvikelwe ukungondleki ngokwensimbi (anemia) kanye nokunciphisa ingozi yokungasebenzi kahle kwamashubhu obuchopho (neural tube defects) ezinganeni ezikhulayo. Kodwa njengoba isayensi yokudla iqhubekela phambili, imikhiqizo eminingi isiqale ukufaka izithako ezintsha ezinikeza indlela ebanzi kakhulu. Kusukela ku-choline kuya kuma-fatty acid e-omega-3, kusukela kuma-probiotic kuya kuzo izitshalo ezikhethiwe ezilinganiselwe kahle, lezi zengezo zibhekana nobubanzi obukhulu bezici zempilo. Abesifazane bavame ukufuna imikhiqizo ehambisana nokushintsha ukunambitheka nokuzwela ngesikhathi sokukhulelwa—kungaba ukushintsha kwamazinyo okuthanda ukunambitheka, isicanucanu sasekuseni, noma ukungabekezelelani kwezinye izithako [1].

Abesifazane abaningi abakhulelwe bayakwazisa ukufakwa kwamavithamini afana no-B12, i-vitamin D3, ne-vitamin K2 ukuze kuvalwe izindlela eziningi zokusebenza komzimba (biochemical pathways). Amafomula esimanje nawo apenya umbuzo wokuthi ingabe ezinye izitshalo nemaminerali amancane (micronutrients) zingasiza yini ekulinganiseni amahomoni, ukuphatha ingcindezi, noma ngisho nasekululameni ngemuva kokubeletha. Ngokugxila kulezi zilinganiso ezibanzi zempilo, izinkampani zizama ukuklama izithasiselo zokukhulelwa eziguquguqukayo ezibonisa ubunzima bokukhulelwa. Nokho, ukungeza konke okusha kudala isidingo sokuhlolwa okuqinile nocwaningo ukuze kuqinisekiswe ukuphepha nokusebenza kahle, ngoba bobabili umama nengane bangathinteka. Lesi sidingo sokuqinisekiswa okuphelele sigcizelela ukuhlolwa okuqinile kwezinqubo zokukhiqiza, ukutholwa kwezithako, kanye nemiphumela engemihle engaba khona.

Izitini Eziyinhloko Zomzimba Wokudla Kwabomama Abakhulelwe

Ifomula ejwayelekile ye-prenatal ivamise ukuqala ngezizakhamzimba eziyisisekelo eziklanyelwe ukukhuthaza ukukhula kombungu nokusekela impilo kamama. I-Folate (noma i-folic acid), ngokwesibonelo, ibhekwa njengebalulekile ekuthuthukisweni kobuchopho, kanti insimbi isiza ekwakheni amaseli egazi abomvu anempilo, abalulekile ekuletheni umoya-mpilo (oxygen) kumbungu. I-Calcium ye-Prenatal, i-magnesium, ne-vitamin D zisekela amandla amathambo, zihlangabezana nesidingo esikhulayo sohlelo lwamathambo lukamama futhi zinikela ekwakhekeni kwamathambo engane. Ngesikhathi esifanayo, i-DHA—i-omega-3 fatty acid etholakala kakhulu ku-omega-3 fish oil—ingasiza ekuthuthukiseni ubuchopho namehlo enganeni ekhulayo.

Nakuba isengezo esisodwa singeke siphindaphinde ukudla okuhlukahlukene, amavithamini e-prenatal ahlinzeka ngesikhuselo esengeziwe ngokumelene nokushoda kokudla. Abantu abakhulelwe bavame ukubhekana nezinselelo ezifana nokuzonda okuthile ekudleni, isicanucanu sasekuseni, noma ubunzima ekuhleleni ukudla. Amafomula e-prenatal anganciphisa eminye yale mikhathazo ngokuhlinzeka ngezinga elizinzile lezizakhamzimba ezibalulekile. Nokho, inani elikhulu lezinketho emakethe lingadida. Ngakho-ke, ukuhlola ngokujulile iphanela lezithako lomkhiqizo ngamunye, ukuvunywa kwezesayensi, kanye nempendulo yabasebenzisi kuba yingxenye ebalulekile yokuthatha izinqumo ezinolwazi. Izindlela ezinhle zanamuhla zokudla zigcizelela ukubambisana phakathi kwezithasiselo nokudla okunomsoco okulinganiselayo, kunokuba zithembele endleleni eyodwa kuphela [2].

Ukubhekana Nezidingo Zempilo Zomuntu Ngamunye Ngesikhathi Sokukhulelwa

Akukho zikhulelo ezimbili ezifanayo ngokuphelele, kanti ukunakekelwa komuntu ngamunye sekube isici esibalulekile sezempilo zabomama zesimanje. Abanye omama abakhulelwe babhekene nezimo ezifana ne-gestational diabetes, umfutho wegazi ophezulu, noma ukungalingani kwezifo zesitho se-thyroid okudinga ukuqondiswa okukhethekile. Abanye bangase balandele imikhawulo ethile yokudla, kungaba ngezizathu zokuziphatha, amasiko, noma ezempilo. Ngalezi zimo ezahlukene, uhlelo lwesithasiselo olufanayo kubo bonke lungase lunganelisi ngaso sonke isikhathi. Amasu okudla ahlelelekile—angase afaka ukulungiswa kwemithamo, isikhathi sokuthatha izakhamzimba, noma ukwengeza izinto eziqondiswe ezindaweni ezithile—ngakho aseyanda.

Ukukhulelwa nakho kushintsha amazinga wamandla, izindlela zokulala, imizwa, nokusebenza kwesisu. Abesifazane bangathola ukuthi izidingo zabo zokudla ziyashintsha ezigabeni ezahlukene zokukhulelwa, okubabiza ukuthi bafune imikhiqizo eguqukayo ihambisane nalezi zinguquko. Ngenxa yalokhu, ezinye izinkampani zakha imikhiqizo yazo ngendlela ehambisana nohambo lokukhulelwa, zilungisa izilinganiso zezizakhamzimba ku-trimester ngayinye. Nakuba le ndlela inganikeza izinzuzo ezikhangayo, iphinde igcizelele isidingo sokugadwa njalo kodokotela, ukuqinisekisa ukuthi lezi zinguquko ziyahambisana nezidingo zomzimba zikamama siqu. Ukunakekelwa okunozwelo, okusekelwe ebufakazini obuvela kochwepheshe bezempilo, kuqinisa ukuqonda okunembile kokuthi izizakhamzimba ezithile zithinta kanjani izidingo eziguqukayo zikamama nengane [3].

Ukuhlola Ukufaneleka Komkhiqizo Ngamazinga Ahlukene

Ngaphambi kokuqoka noma yisiphi isithasiselo sokukhulelwa, abantu abakhulelwe bavame ukuhlola ukuthi umkhiqizo uhambisana kanjani nezinkolelo zabo kanye nempilo yansuku zonke. Lokhu kubandakanya ukubuza imibuzo mayelana nesiqinisekiso sekhwalithi, ukuthi izithako zitholakala kanjani, okungenzeka ukuthi kube khona izinto ezenza umzimba ungabekezeleli, noma ukuthi isithasiselo sakhiwe kanjani. Ngokuba nezinketho eziningi kangaka zamavithamini e-prenatal, ukuphenya ngezitifiketi zomkhiqizo noma ukucaca kolwazi kungaba yisinyathelo esisebenzayo. Abathengi bangakhetha imikhiqizo ehlolwa izinkampani ezizimele (third-party testing) ukuze kuqinisekiswe ukunemba kwamalebuli noma ukuqinisekisa ukuthi acwebile ezinhlanganisweni eziyingozi.

Ngaphezu kokuqinisekiswa kwesayensi, ukonga kungathinta izinqumo zokuthenga. Ezinye izinkampani zibiza amanani aphezulu ngenxa yezithako ezikhethekile noma amafomula ahloswe izimakethe ezincane. Kubomama abacabanga ngezimali, enye indlela engeke ibe yimbi kungaba umkhiqizo wendabuko we-prenatal ohlinzeka ngezidingo eziyisisekelo zokudla ngaphandle kwezinto ezengeziwe. Umgomo wokugcina uwukuthola umkhiqizo ohambisana kalula nempilo yansuku zonke kodwa ugcine ukuphepha nokwakhiwa okusekelwe ebufakazini. Kule ndlela, ukuhlolwa okunembile kwamazinga amaningi—okwesayensi, okusekelwe ezipiliyoni, okokuziphatha, nasekwezimali—kungaholela esinqumweni esithembekile kakhulu [4].

Ukucabangisisa Ngemibono Yomphakathi (Ukuhlanganiswa kwe- “perelel reviews”)

Phakathi kwenqwaba yezinketho zezithasiselo, eminye imikhiqizo idonsela ukunakwa okukhethekile emiphakathini eku-inthanethi exoxa ngezinhlobonhlobo ezincane phakathi kwezithasiselo ezahlukene zokukhulelwa. Kulezi zixoxwano, izibuyekezo ze-perelel zivame ukuvela, ikakhulukazi kubantu asebehlolile imikhiqizo ehlukahlukene ukuze balwe nokungakhululeki okuhambisana nokukhulelwa noma ukuvumelanisa nezidingo zokudla ezishintshayo. Izinkulumo eziningi ziveza ukuthi amafomula ahlukaniswe ngezigaba (multi-stage), amazinga ezizakhamzimba aqondiswe endaweni ethile, nezithako ezicwaningiwe kahle zingawenza umehluko phakathi komkhiqizo nomunye. Ukubuka lezi zingxoxo kungaba yindawo yokuqala ewusizo kulabo abangaqiniseki ukuthi yimuphi umkhiqizo ohambisana kangcono nendlela yabo yokuphila. Nakuba kucacile ukuthi awekho ama-brand azosebenza kubo bonke abantu, ukufunda ngezinto ezenzeka kwabanye kusiza ekukhombeni imibuzo engaxoxwa nodokotela [5].

Umugqa Wokugcina

Izibuyekezo ze-perelel prenatal zivame ukugqamisa ukudibana phakathi kokudla okuthuthukile nesipiliyoni somsebenzisi, okukhombisa ushintsho olubanzi lamasiko lokuthatha izinqumo ezinolwazi ngesikhathi sokukhulelwa. Ukukhetha isithasiselo sokukhulelwa esifanele kuhlala kuyisinqumo somuntu siqu kakhulu, esakhekayo ngeluleko lodokotela, umzimba womuntu ngamunye, nezimo zokuphila. Ngokuthuthuka okuqhubekayo kwesayensi yokukhulelwa, abesifazane abaningi nochwepheshe bezempilo sebepheqa amafomula anemininingwane ahlanganisa amavithamini abalulekile, amaminerali, nezinye izithako ukuze kubhekwe izidingo eziguqukayo zokukhulelwa. Ngenkathi impendulo yabasebenzisi ingakhanyisa izinzuzo noma imikhawulo emincane, kubalulekile ukuyibeka ngokulinganayo nokuhlolwa kochwepheshe.

Ngenkathi imakethe yezithasiselo zokukhulelwa iyaqhubeka nokwanda, abazali abazolayo bazithola sebebhekene nemikhiqizo ekhethekile ngokwengeziwe ehloselwe ukuhlangabezana nezidingo ezahlukene. Ngokuhlola amaphrofayela ezithako, ukuqonda izimiso eziyinhloko zokudla, nokubonisana nemithombo ethembekile, umuntu angathatha isinqumo esinamandla. Umgomo uwukudala indawo esekelayo lapho omama nezingane ezikhulayo bechuma khona. Ekugcineni, noma yiliphi isithasiselo se-prenatal kufanele lisebenze njengengxenye yohlelo oluphelele olubandakanya ukudla okunomsoco okulinganiselayo, ukuphumula okwanele, nokuxoxa ngokungafihliseli nodokotela phakathi nesikhathi sokukhulelwa nangemva kokubeletha. Umphumela awusona nje ukukhetha umkhiqizo, kodwa ukuzibophezela empilweni eqhubekayo yomama nengane.

Izinkomba

1. O'Leary F, Samman S. Vitamin B12 empilweni nasezigulini. Nutrients. 2010 Mar;2(3):299-316. doi: 10.3390/nu2030299. Epub 2010 Mar 5. PMID: 22254022; PMCID: PMC3257642.
2. Pérez-López FR, Pilz S, Chedraui P. Ukuthathwa kwe-vitamin D ngesikhathi sokukhulelwa: ukubuka konke. Curr Opin Obstet Gynecol. 2020 Oct;32(5):316-321. doi: 10.1097/GCO.0000000000000641. PMID: 32487800.
3. Marshall NE, Abrams B, Barbour LA, Catalano P, Christian P, Friedman JE, Hay WW Jr, Hernandez TL, Krebs NF, Oken E, Purnell JQ, Roberts JM, Soltani H, Wallace J, Thornburg KL. Ukubaluleka kokudla ngesikhathi sokukhulelwa nokuncelisa: imiphumela yempilo yempilo yonke. Am J Obstet Gynecol. 2022 May;226(5):607-632. doi: 10.1016/j.ajog.2021.12.035. Epub 2021 Dec 27. PMID: 34968458; PMCID: PMC9182711.
4. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Harrison M, umhleli. Nutrition During Pregnancy and Lactation: Exploring New Evidence: Proceedings of a Workshop. Washington (DC): National Academies Press (US); 2020 Jul 31. 5, Dietary Supplements. Kuyatholakala ku- https://www.ncbi.nlm.nih.gov/books/NBK562622/
5. Nazik E, Eryilmaz G. Inani lokungakhululeki okuhlobene nokukhulelwa nezindlela zokuphatha ukulinciphisa phakathi kwabomama abakhulelwe. J Clin Nurs. 2014 Jun;23(11-12):1736-50. doi: 10.1111/jocn.12323. Epub 2013 Sep 13. PMID: 24028734.