Preconception care is important for ensuring a woman’s health before pregnancy, but few women take advantage of it. It can benefit healthy women with advice on pregnancy preparation, and those with medical conditions or family history of genetic disorders. Screening and managing medical issues, as well as advising on safe medications, are also part of preconception care.
Preconception care is an aspect of medicine that ensures that a woman is in excellent health before becoming pregnant. While this type of care can be beneficial for both healthy women and those with chronic medical conditions, relatively few women take advantage of it. For women who have a family history of genetic disorders, suffer from certain medical conditions or use prescription drugs, it is of particular importance to obtain counseling before becoming pregnant in order to ensure the health of their babies.
Healthy women can benefit from preconception care for a variety of reasons. They can get advice on what to expect during pregnancy. Doctors may advise these women to start taking folate in preparation for pregnancy because it is crucial for women to have high levels of this vitamin in their blood during the early stages of pregnancy to prevent their babies from developing spinal cord defects. Doctors often suggest that women take general steps to ensure good health, such as maintaining a normal weight, exercising regularly, eating a healthy diet, giving up smoking, and consuming alcohol in moderation.
Certain groups of women are at an increased risk of having babies with genetic disorders and may benefit from preconception genetic screening. For example, people of Ashkenazi Jewish descent are at risk for Tay-Sachs disease, and couples within this group are routinely tested to see if they are a carrier of this disease before attempting to conceive. Many African Americans are carriers of sickle cell disease and screening of prospective parents may be warranted in this population, especially if there is a history of family members with the disease. Caucasian couples who have family members with cystic fibrosis can also be tested to see if their children may be at risk for the condition.
Some known medical issues need to be addressed as part of proper preconception care to ensure that women with these conditions have healthy pregnancies. Women suffering from diabetes mellitus should make sure their blood glucose levels are well controlled before becoming pregnant. Some autoimmune disorders such as lupus should also be managed before becoming pregnant, as these disorders can sometimes worsen after conception. Women with phenylketonuria, a rare metabolic disorder that interferes with the ability to break down some proteins, should have a special diet before becoming pregnant to prevent complications in their developing babies.
As part of preconception care, women can also be advised which medications they can continue to take. Some pharmaceutical agents are known teratogens, which means they can cause an increased risk of birth defects. For example, the blood thinner warfarin should be stopped before becoming pregnant if possible. Women with bipolar disorder might be taking medications like valproic acid or lithium which are also known to cause birth defects. Some blood pressure medications should also be stopped.
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