The vital role of preconception care in ensuring healthy pregnancies

In his first online article of a two-part series on preconception care, Dr Panicas Shangaris gives us his insights. He talks about the key aspects of preconception care that women should be aware of before planning their pregnancy, how preconception care contributes to a healthy pregnancy and reduces the risk of complications.

What are the key aspects of preconception care that every woman should be aware of before planning a pregnancy?

Preconception care is an important aspect of reproductive health that focuses on ensuring the well-being of both the woman and the potential baby before pregnancy occurs.

Here are some key aspects that every woman should be aware of before planning a pregnancy:

1. Consult with a healthcare provider: Schedule a preconception visit with a healthcare provider, such as your GP or an obstetrician. They can evaluate your overall health, discuss your medical history, and provide personalised advice based on your specific circumstances.

2. Review medical conditions and medications: Discuss any existing medical conditions, such as diabetes, hypertension, or thyroid disorders, with your healthcare provider. Ensure that your conditions are well-managed and optimised for pregnancy. Similarly, review your medications, as some may need to be adjusted or changed due to potential risks during pregnancy.

3. Achieve a healthy weight: Maintaining a healthy weight before pregnancy is important for both the mother's and baby's health. Being overweight or underweight can increase the risk of complications during pregnancy. Your healthcare provider can help you determine a healthy weight range and provide guidance on diet and exercise.

4. Take folic acid supplements: Folic acid is crucial for preventing neural tube defects in the developing fetus. Start taking a daily folic acid supplement (typically 400 micrograms) at least 2 to 3 months before conception and continue throughout the early stages of pregnancy.

5. Assess immunisation status: Review your immunisation records to ensure you are current on important vaccines. Some diseases, such as rubella and varicella, can cause significant harm to the developing baby. If necessary, update your immunisations before becoming pregnant.

6. Manage chronic conditions: If you have a chronic condition like asthma, epilepsy, or depression, work with your healthcare provider to ensure it is well-managed before pregnancy. Optimal control of chronic conditions can help minimise potential risks during pregnancy.

7. Avoid harmful substances: It is essential to avoid tobacco, alcohol, and recreational drugs, as they can have detrimental effects on fertility and increase the risk of birth defects and other complications during pregnancy. Minimise exposure to environmental toxins and occupational hazards as well.

8. Review genetic and family history: Discuss your family medical history with your healthcare provider, as certain genetic conditions can be passed on to your children. If necessary, your healthcare provider may recommend genetic counselling or testing.

9. Adopt a healthy lifestyle: Focus on maintaining a healthy lifestyle by following a nutritious diet, engaging in regular exercise (at least 30 minutes a day, 5 days per week), getting adequate sleep, and managing stress levels. These lifestyle factors can positively impact your fertility and overall pregnancy experience.

10. Manage mental health: Mental health plays a significant role in preconception care. Address any concerns about anxiety, depression, or other mental health conditions with your healthcare provider. They can provide appropriate support and guidance.

Remember, every woman's preconception care needs may vary. Working closely with a healthcare provider is crucial to address individual circumstances and ensure the best possible start for a healthy pregnancy.

How does preconception care contribute to a healthy pregnancy and reduce the risk of complications?

Preconception care is the provision of health interventions before pregnancy to improve health outcomes for women and infants. The goal of preconception care is to detect and manage risk factors that could affect a future pregnancy. This can significantly contribute to a healthy pregnancy and reduce the risk of complications in various ways.

1. Nutritional counselling: Through preconception care, women are advised about the importance of maintaining a balanced diet, achieving an ideal body weight, and taking necessary vitamin and mineral supplements, especially folic acid, which can reduce the risk of neural tube defects.

2. Lifestyle modifications: Preconception care helps women to adopt healthy lifestyle habits such as quitting smoking, abstaining from alcohol, avoiding illicit drugs, and getting regular exercise. These changes can decrease the risk of pregnancy complications like premature birth, low birth weight, and fetal alcohol syndrome.

3. Managing existing health conditions: Preconception care involves assessing and managing existing medical conditions such as diabetes, hypertension, and mental health disorders. Uncontrolled health conditions can lead to complications during pregnancy for both the mother and the baby. The treatment plan may be adjusted safely before getting pregnant to ensure it doesn't harm the developing fetus.

4. Immunisation status check: Preconception care checks a woman's vaccination status to reduce the risk of preventable diseases that can be harmful during pregnancy.

5. Genetic counselling and testing: If there's a family history of genetic disorders or if the woman is of an age or ethnicity that puts her at higher risk, genetic counselling and testing can help predict the likelihood of having a child with a genetic disorder.

6. Mental health evaluation: Mental health plays a significant role in pregnancy. Preconception care addresses any mental health issues, like depression or anxiety, which can affect pregnancy and postpartum health.

7. Education and counselling: Preconception care provides education about what to expect during pregnancy, signs of complications, breastfeeding, newborn care, and more. This can help women to be prepared for pregnancy and parenthood.

8. Medication review: Some medications harm the fetus and must be changed or adjusted before a woman becomes pregnant.

9. Identifying social risk factors: Preconception care also identifies social and behavioural risk factors such as domestic violence or substance abuse and provides interventions and resources to address these.

10. Optimisation of oral health: Poor oral health can contribute to adverse pregnancy outcomes. Preconception oral health evaluation and treatment can help in preventing such outcomes.

By addressing these areas before pregnancy, preconception care can contribute significantly to a healthy pregnancy and reduce the risk of complications. It's advisable for all women of reproductive age to receive preconception care, whether they plan to become pregnant, because many pregnancies are unplanned, and health optimisation takes time.

Dr Panicas Shangaris is an esteemed consultant obstetrician with over 15 years of experience. You can schedule an appointment with Mr Shangaris on his Top Doctors profile.