Babe In My Heart, Blogs

What To Do Before You Do… It

July 6, 2017

Written by Dr. Amanda McDonough, Guest Blogger

Healthy moms are without a doubt more likely to have healthy pregnancies. Prioritizing health before conception can lead to improved fertility and less pregnancy complications. Ideally women will have a formal preconception visit with their obstetrician gynecologist.
Healthy Lifestyle
The obesity epidemic has significantly affected women’s reproductive health and pregnancy outcomes. Obesity is associated with multiple chronic diseases, infertility and poor pregnancy outcomes. Obese women are at higher risk of miscarriage and stillbirth. The risk of diabetes in pregnancy, hypertension with preeclampsia, and cesarean section is also increased for obese mothers. Starting a healthy diet and exercise program prior to pregnancy can improve fertility and pregnancy outcomes. Nutrition counseling may be beneficial. Thirty minutes of moderate exercise per day is recommended. Calculating your body mass index can be done easily here

BMI

<18.5 Underweight
18.5-24.9 Normal (GOAL)
25-29.9 Overweight
>30 Obese

Substance Use
Tobacco use is associated with infertility and poor pregnancy outcomes. Smoking cessation should be a goal prior to conception. Alcohol use is associated with fetal alcohol syndrome. There is no amount of alcohol considered safe in pregnancy. Opioid dependence is a growing concern in pregnancy. Methadone or Subutex programs are available and considered safer than illicit drug use during pregnancy. Neonatal abstinence syndrome is associated with opioid use during pregnancy.


Vitamin Supplementation
All women of childbearing age should be taking a prenatal vitamin with folic acid (400 micrograms). Conditions that impact the fetus’s brain and spinal cord development, known as neural tube defects, can be prevented with adequate folic acid supplementation prior to conception. The neural tube closes approximately six weeks after conception which is typically when most women discover they are pregnant. Therefore, vitamin supplementation should occur prior to conception to have the greatest impact.
Chronic Medical Conditions
Many women are seeking careers that require higher education, which is FANTASTIC, but that means childbearing is typically delayed. As women age they may develop chronic diseases such as diabetes and hypertension. Working with your primary care physician to optimize your health before conception is extremely beneficial for mom and baby!
Carrier Screening
Women can choose to have carrier screening prior to pregnancy to determine if they carry genes that can lead to multiple conditions including cystic fibrosis, Tay Sachs, fragile X syndrome and sickle cell disease. This is typically a blood test. If maternal carrier screening is positive the partner can be tested to see if there is a risk of having an affected fetus. The couple can meet with a genetics counselor to discuss their risk and options.
Prioritizing women’s health prior to pregnancy leads to healthier moms and babies!

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