Preconception Care ~ Making Healthy Babies

Creating a healthy baby first involves creating health in the parents. Implementing good health practices before pregnancy occurs, as in preconception care, can help avoid fertility problems, problems in pregnancy and birth, and problems in the health of mom and the baby. Good preconception care focuses on protection for conditions and risk factors that could affect a woman when she becomes pregnant and by focusing on factors that can affect a developing fetus or infant. Such factors may include taking prescription drugs or drinking alcohol. The key to promoting preconception health is to combine the best medical care, healthy behaviors, strong support, and safe environments at home and at work (CDC, n.d.).

After pregnancy occurs prenatal care begins to continue with prevention of problems that can occur with the developing baby. It also may involve genetic counseling related to birth defects. This is also the time to prepare for when baby arrives (CDC, n.d.).

According to the Center for Disease Control, while there has been many advances in medicine and prenatal care in recent years, compared to any other developed country, birth outcomes are worse in the United States. Often U.S. babies are born prematurely or have a low weight birth. These problems are even escalating in some groups of people (CDC, n.d.).

To help address this problem, good preconception care is recommended. What is preconception care? The goal of preconception care is to improve the health of the mother before pregnancy occurs in order to reduce risks of mother and/or the child during pregnancy and beyond birth. Preconception care also involves health and lifestyle of the father (CDC, n.d.).

It is suggested to implement “5 Steps to get ready for a healthy pregnancy” (CDC, n.d.).

These include:

1. Take 400 micrograms (mcg) of Folic Acid every day for at least 1 month before getting pregnant (CDC, n.d.).
   1. Folic acid supplements are taken to prevent neural tube defects (CDC, n.d.).
   2. An appropriate amount of folic acid can also help prevent cleft lip and congenital heart disease. Since these birth defects often happen before most women know they are pregnant (MyPyramid.gov, 2008), folic acid supplementation is beneficial as part of a preconception plan.
2. Avoid smoking and drinking alcohol (CDC, n.d.).
   1. Smoking is linked to premature birth and low birth weight. It is also linked to children having higher range of physical and cognitive disabilities (Crandell, Haines Crandell, & Vander Zanden, 2009). Quit before getting pregnant to avoid these risks.
   2. Drinking alcohol causes Fetal Alcohol Syndrome which is the most common cause of mental retardation. This is very preventable (Crandell et al., 2009). The benefits of avoiding alcohol by far out way the risks.
3. If you have a medical condition, be sure it is under control and being treated properly (CDC, n.d.).
4. Take any needed medications appropriately under the advisement of a health care professional (CDC, n.d.).
   1. Since medications taken during pregnancy account for 1 to 3 percent of birth defects (Crandell et al., 2009) it is a good idea to avoid taking drugs unless they are necessary for a serious health condition (Crandell et al., 2009).
5. Avoid contact with toxic substances, poisons, harmful chemicals, and cat or rodent feces (CDC, n.d.).
   1. Avoid marijuana; oral contraceptives; caffeine in coffee, tea, chocolate, cola drinks; cocaine and other hard drugs; and avoid exposure to toxins in the workplace (Crandell et al., 2009).
   2. It’s also advisable for men to be aware of chemicals in the work environment that can be carried in the semen and can cause infertility in the man, lead to miscarriage (spontaneous abortion), and congenital malformations (Crandell et al., 2009).

Put into place your Preconception Plan ahead of time! Create a reproductive life plan and stick to it. This consists of personal goals set for family planning (CDC, n.d.).

A reproductive plan is not only beneficial for women but for men as well. A family health history of both can be addressed at this time.

Families share their genes, their environment, lifestyles and habits. Taking a look at family history helps identify a possible increased risk for disease. Health history reflects for both, a person’s genes and these other shared risk factors (CDC, n.d.). This helps with understanding genetic risks (CDC, n.n.). Some people have concerns of passing along genetic diseases to their children. This includes Down Syndrome, which occurs in 1 out of every 800 live births in the U.S. (Crandell et al., 2009). People of African descent may pass to their children sickle-cell anemia. Tay-Sachs disease is a genetic defect in Ashkenazic Jews (Crandell et al., 2009). Decisions can be made at this time whether or not genetic counseling would prove beneficial.

One of the 5 steps to preconception health involves addressing health conditions prior to pregnancy. Some diseases, both infectious and noninfectious, can have a teratogenic effect. This means there is a risk that the disease in the mother can cause birth defects or death in the baby.

Some diseases in mom that can lead to birth defects in baby are (Crandell et al., 2009):

• Rubella – miscarriage, cardiac abnormalities, deafness, blindness, mental or physical retardation
• Chlamydia – conjunctivitis or blindness, pneumonia
• Trichomoniasis – premature birth or low birth weight
• Human Papillomavirus (HPV) – premature birth or low birth weight
• Syphilis – brain and spinal cord damage, death
• Genital herpes – sores around the mouth, central nervous system damage, miscarriage, death of infant
• Gonorrhea – conjunctivitis or blindness, pneumonia
• HIV – bacterial infections, cancer, swollen lymphs, failure to thrive, neurological damage, developmental delays, death
• Diabetes Mellitus (type 1) – congenital malformations, neurological defect, respiratory distress, miscarriage, still born
• Diabetes Mellitus (type 2) – fetal obesity, complications with labor and birth, neural tube defects, respiratory distress, miscarriage, still born

(Crandell et al., 2009)

Other health issues that can lead to birth defects should be address at this time. These include hypothyroidism, Hepatitis B, PKU, hypertension, blood diseases, eating disorders (CDC, n.d.).

During this time, men should be screened and treated, if necessary, for STIs (sexually transmitted infections) to help avoid passing infections to female partners. Men can also improve their own reproductive health. They can work on reducing stress, eating a healthy diet, getting any medication issues addressed, avoiding excessive alcohol use, and avoiding smoking. It is important for men who do smoke to avoid smoking around their partners. This helps her to avoid the harmful effects of second-hand smoke (CDC, n.d.).

Expecting parents hope the baby they bring into the world is healthy, and that he or she grows into being a healthy and happy child. Fortunately having a healthy child is not only something to hope for, but something parents-to-be can take a proactive approach to make happen. Good preconception and prenatal care go a long way to creating a healthy baby!

See our Before, During, and After Pregnancy Page!

References:

Bodnar, L.M., Catov, J.M., Simhan, H.N., Holick, M.F., Powers, R.W., and Roberts, J.M. (2007). Maternal vitamin D deficiency increases the risk of preeclampsia.
Journal of Clinical Endocrinology Metabolism, 92. 3517-3522.

CDC – Pregnancy, Before You Get Pregnant – NCBDDD. (n.d.). . Retrieved November 21, 2010, from http://www.cdc.gov/ncbddd/pregnancy_gateway/before.html

Colagar, A.H., Marzony, E.T., & Chaichi, M.J. (2009). Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men, Nutrition Research, 29(2), 82-88. doi: 10.1016/j.nutres.2008.11.007.

Crandell, T.L., Haines Crandell, C., & Vander Zanden, J.W. (2009). Human Development. (9^th ed.). Boston: McGraw-Hill Higher Education.

Freeman, M.P., Hibbeln, J.R., Wisner, K.L., Davis, J.M., Mischoulon, D., Peet, M., Keck Jr., P.E., Marangell, L.B., Richardson, A.J., Lake, J., & Stoll, A.L. (2006). Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. Journal of Clinical Psychiatry, 67(12). 1954-1967.

Holick, M.F. (2007). Vitamin D deficiency. New England Journal of Medicine. 357, 266-281.

Misra, M., Pacaud, D., Petryk, A., Collett-Solberg, P. F., Kappy, M., & on behalf of the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. (2008). Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations. Pediatrics, 122(2), 398-417. doi:10.1542/peds.2007-1894

United States. Department of Agriculture. MyPyramid.gov (2008). Dietary supplements. Retrieved November 23, 2010, from http://www.mypyramid.gov/mypyramidmoms/dietary_supplements_prenatal_print.html