Getting an Early Start on Prenatal Care
Preconception preparation can mean fewer problems

(HealthDay News) -- Even if you're just thinking about getting pregnant, now's the time to mind your health and talk to a doctor.

Planning ahead, experts say, is the best way to prevent and manage health issues that require action before conceiving or early in the pregnancy.

"It's always easier to try to prevent a problem than to catch up with it later on," Dr. Lorey H. Pollack, director of obstetrics and gynecology at Mercy Medical Center in Rockville Centre, N.Y., told HealthDay .

A report by a panel of experts hosted by the U.S. Centers for Disease Control and Prevention established four specific goals and 10 recommendations for improving health and pregnancy outcomes in the United States .

The panel encouraged "preconception care," defined as specific interventions aimed at identifying and modifying medical, behavioral and social risks to a woman's health or pregnancy outcome.

"Preconception care should be an integral part of routine primary care and serves as an opportunity to screen for current and future health risks, to provide health promotion messages and education, and to offer interventions that address identified risks," the panel wrote.

Despite efforts to improve prenatal care in the United States, each year 12 percent of babies are born premature, 8 percent are born with low birth weights and 3 percent have major birth defects, the CDC reports. About 31 percent of women giving birth suffer complications during pregnancy.

What's more, risk factors linked to poor pregnancy outcomes persist among women of childbearing age, the CDC says. For example, 11 percent smoke during pregnancy and 10 percent consume alcohol.

The panel's report recommends behaviors to avoid as well as things that women should do before they conceive. Among the most important is folic acid supplementation.

"Daily consumption of 400 micrograms of folic acid before or early in pregnancy can reduce the occurrence of neural tube defects," Dr. Hani K. Atrash, associate director for program development at the CDC's National Center on Birth Defects and Developmental Disabilities and a co-author of the report, told HealthDay .

A study presented at the 2008 annual meeting of the Society for Fetal-Maternal Medicine underscores the importance of this recommendation. The study, which involved more than 38,000 women, suggested that women who take folic acid for at least a year before becoming pregnant could cut their risk of premature delivery by half.

Experts advise that, before becoming pregnant, women can do other things as well to reduce risks:

• Stop smoking and drinking alcohol.
• Be sure any medical conditions are under control and that vaccinations are up to date.
• Talk to a doctor or pharmacist about any over-the-counter and prescription medicines being taken, including vitamins and dietary or herbal supplements.
• Avoid exposure to toxic substances or potentially infectious materials at work or at home, including chemicals or cat and rodent feces.

"If a woman or couple has decided to conceive, then at least one pre-pregnancy visit is recommended," Atrash said.

And, yes, men have a role to play in preconception care as well. When planning a pregnancy, it's important to understand the genetic risks on both the mother's and the father's side of the family, the CDC says. And, screening and treating any sexually transmitted diseases in men can help prevent the spread of such diseases to their partners.

Other things men can do to promote good preconception health include:

• Encourage and support your female partner.
• If you work around toxins or chemicals, take care not to expose your partner to them. Change out of dirty work clothes before coming near your female partner. Handle and wash soiled clothes separately.
• Improve your own reproductive health by reducing stress, eating right, avoiding excessive alcohol use, not smoking and talking to a doctor about any medications you're taking.
• Stop smoking around your partner to avoid the harmful effects of second-hand smoke.

On the Web

To learn more about preconception planning, check out information provided by the March of Dimes.

SOURCES: HealthDay News ; Lorey H. Pollack, M.D., director of obstetrics and gynecology, Mercy Medical Center, Rockville Centre, N.Y.; Hani K. Atrash, M.D., M.P.H., associate director of program development, National Center on Birth Defects and Developmental Disabilities, U.S. Centers for Disease Control and Prevention, Atlanta; Proceedings of the Preconception Health and Health Care Clinical, Public Health and Consumer Workgroup Meetings , June 27-28, 2006, Atlanta; Jan 31, 2008, news release, March of Dimes Foundation, White Plains, N.Y.; National Center on Birth Defects and Developmental Disabilities, CDC (http://www.cdc.gov/ncbddd/)
Author: Karen Pallarito
Publication Date: July 31, 2008
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