Eggs are considered a vital component to a woman's diet during pregnancy based on their nutrient content (choline), which has been shown to be beneficial for fetal growth – especially the fetal brain.
The historical link between eating eggs and a higher risk for heart disease has been disproven. Decades of research since that association first appeared contradicts the idea that egg cholesterol content has any link to cardiovascular health, and numerous countries removed upper limits for cholesterol in their dietary guidelines.
It is important to handle eggs safely and avoid consuming raw, unpasteurized egg in batters, doughs, icings, and other food items due to the risk of food-borne illness. There are pasteurized eggs and egg products that are safe to consume raw in certain recipes.
Women who are vegan or those with egg allergies can obtain enough choline during pregnancy through other, more targeted food choices.
Women should continue reading below to learn more about the nutrition in eggs, egg safety – including cooking and handling recommendations – as well as risks associated with backyard chickens.
Background
The nutrients in eggs are necessary for proper fetal development. Eggs provide numerous vitamins, minerals, and other nutrients such as zinc, vitamin D, vitamin E, vitamin B12, folate, iodine, selenium, omega-3 fatty acids, and protein; further, its saturated fat content is mostly monounsaturated.
Eggs were traditionally associated with cardiovascular concerns, mainly due to their cholesterol content. However, this is now known to have been very misleading. Cardiovascular disease is no longer solely considered a matter of blood cholesterol, but also medical history, ethnicity, genetics, hormones, weight, age, and overall diet.
Eggs have a saturated fat content of about 3 grams (g)/100 g and cholesterol content of about 200 to 300 milligrams (mg)/100 g. In general, reducing saturated fat intake was the primary strategy recommended for reducing cholesterol, which led to a reduction in egg consumption.
It has since been determined, with over 30 years of high-quality research, that cholesterol in eggs has little to no effect on blood cholesterol, and the nutrient content of eggs outweighs any potential risks.
It required a much greater amount of research to prove that egg intake was unrelated to cardiovascular disease risk than to conclude it was related.
Based on this data, many countries removed dietary cholesterol restrictions from their national dietary guidelines, to include Australia, Great Britain, Ireland, and the United States.
Pregnancy
Although there is limited data regarding egg consumption during pregnancy, most studies have focused on the positive effects of eggs enriched with omega-3 and omega-6 fatty acids on infants’ growth and brain, visual, cognitive, and intellectual development.
Pregnant women and their babies can benefit from egg consumption just three times a week, which is unlikely to cause any negative health concerns.
Eggs are also a rich source of choline, a nutrient critical for brain and memory development in fetuses and infants. Choline is theorized to be as important for brain/neural development as folic acid.
One large egg contains 125 mg of choline; it is recommended pregnant women aim for 450 mg/day (other sources include salmon and other fish, meat, poultry, dairy products, and soybeans).
Safety
Eggs are commonly available, low in cost, and can be prepared in a variety of ways, but must be handled and cooked properly to avoid becoming sick.
Eggs are among the most common causes of Salmonella infection, the frequency of which ranges from 1 infected egg per 10,000 to 30,000 eggs. Eggs become infected with salmonella from poultry droppings, being laid in an infected area, or from bacteria within the hen's ovary or oviduct before the shell forms around the yolk and white.
The shell (of a clean, unbroken egg), the egg yolk, egg white, and the packaging containing the eggs all have the potential to be infected. Washing hands after cracking eggs, touching the package or even just the shell can completely eliminate risk – no matter how slight – and only takes 20 seconds.
Salmonella usually presents with fever and nausea, vomiting, stomach cramps, and diarrhea; bacteremia occurs in approximately 4% of cases, which may lead to intrauterine sepsis (bacteria in bloodstream).
Certain guidelines should be followed when handling, storing, and eating eggs or foods than contain eggs:
In general, pregnant women should avoid consuming raw and undercooked eggs, to include homemade foods that often contain raw eggs such as mayonnaise and salad dressings, custards and ice creams, and raw cookie dough and cake batter unless pasteurized eggs have been used.
Pasteurized eggs can be purchased (including in the shell, liquid, frozen, and powdered form); eggs pasteurized in the shell are heated enough to kill bacteria, but not to cook the egg.
Commercial products are made using pasteurized eggs; therefore, these items are safe to consume (pregnant women should read the label to make sure and look for the word “pasteurized”).
In the United States, eggs should be stored in the refrigerator.
Hands and any utensils or surfaces should be washed thoroughly after contact with raw eggs, especially the shell.
Eggs should be cooked until the yolks and whites are firm (and scrambled eggs are dry and firm).
Baked egg mixtures such as quiches, frittatas, egg and French toast casseroles should be baked until the center of the mixture reaches 160 °F.
Women should avoid icing, meringue, and whipped topping recipes that use raw egg whites; frostings and meringues made by combining hot sugar syrup with beaten egg whites are safe to eat.
Action
Pregnant women should handle eggs safely and avoid consuming raw, unpasteurized egg in batters, doughs, icings, and other food items due to the risk of food-borne illness.
Women should learn more about salmonella, as well as the signs and symptoms of the infection.
Women who are vegan or those with egg allergies can obtain enough choline during pregnancy through other, more targeted food choices.
Women who are concerned about their saturated fat or cholesterol intake during pregnancy should have a discussion with their health care provider (HCP). HCPs can also provide an assessment regarding a woman's overall diet and offer advice or recommendations to help her obtain as much nutrition as possible during pregnancy.
Partners/Support
Partners can do their part in keeping food items safe by handling eggs properly as described above, to avoid contaminating any food item that may be ingested by the pregnant woman (as well as all other family members) (see Resources section).
Salmonella can be serious during pregnancy. Read more here. Further, partners can learn the signs and symptoms of salmonella infection, to help recognize if any family members may have been contaminated, which can result in earlier diagnosis and treatment.
Resources
Food Safety (All Source Pregnancy)
Salmonella (All Source Pregnancy)
Egg Storage Chart (FoodSafety.gov)
Egg Safety and Eating Out (FoodSafety.gov)
Tips to Reduce Your Risk of Salmonella from Eggs (U.S. Centers for Disease Control and Prevention)
Playing it Safe With Eggs: What Consumers Need to Know (U.S. Food and Drug Administration)
Consumer Information about Egg Safety (U.S. Food and Drug Administration)
Egg Products and Food Safety (U.S. Department of Agriculture)
Shell Eggs from Farm to Table (U.S. Department of Agriculture)