Introduction:
For couples thinking about having a baby, following pre-pregnancy planning with the advice of a trained healthcare professional can lower the risk of problems during pregnancy and post-delivery. A healthcare provider can suggest and guide through ways to get adequate nutrition and restrict habits that can pose lasting harmful effects on a baby. Hence, a healthy couple is more likely to have a healthy pregnancy and a healthy child during conception time.
What Is the Importance of Pre-pregnancy Planning for Females and Males?
The preconception period is usually considered three months before conception. However, it can only be identified after the pregnancy. Thus, the ideal pre-pregnancy planning period is when a couple decides to have a baby. Pre-pregnancy planning gives a couple of opportunities for assessing and correcting the following essential aspects in both men and women.
1. Assessment for Risk: Both females and males must undergo assessment for conditions posing risks associated with poor pregnancy outcomes. This risk assessment includes an evaluation of overall health, medical history, social and behavioral risks, surgical risks, medication risks, occupational risks, and any other issues that may pose a risk to fertility or pregnancy.
2. Chronic Diseases: Any female with a chronic disease should consult with the healthcare provider as pregnancy can raise the risks for both the baby and the mother, requiring additional visits to the doctor, change in routine care, and possible hospital stays may increase if the issues during pregnancy period and delivery are not optimal. Pre-pregnancy consultation with a doctor focuses on enhancing primary and secondary prevention, treatment compliance, and overall well-being improvement before becoming pregnant. The health care provider will review any known risks, including a disease history and status, medications, social barriers, and support systems limitations or financial obstacles. The primary health care provider may advise further counseling with a specialist doctor to discuss the possible changes in medicines during pregnancy in case there are diseases or health problems associated with progressions during pregnancy, such as severe anxiety and depression, seizure disorders, cardiac, renal disease, diabetes, and other long-term illnesses.
3. Genetic Disorders or Carrier of Them: The doctor will refer families with a history of genetic disorders to a genetic counselor to assess the risks of passing a genetic disorder to the baby. The genetic counselor can also provide information regarding conditions that might impact fertility.
4. Folic Acid: There is clear evidence establishing the protective effect of folic acid on the occurrence of neural tube defects. Moreover, the failure in the closure of the neural tube is the cause of neural tube defect, which occurs approximately 28 days after conception. During this time, most women are not aware of their pregnancy. Therefore, They might miss the chance of preventing neural tube defects, which demands sufficient concentration of folic acid in the mother's body before conception to reduce the risk of anemia and neural tube defects. Hence, the doctor recommends that women and males also take folic acid and eat dietary folic acid-fortified foods. The health care provider may prescribe more than regular folic acid supplement doses to a woman having a higher risk of having a baby with a neural tube defect.
5. Pre-pregnancy Planning About the Time: Short-interval pregnancies under 18 months are linked with preterm deliveries, maternal morbidity and mortality, premature rupture of membranes, bleeding in the third trimester, and anemia. Counseling about this negative impact reduces the chances of short-interval pregnancies.
6. Abusive Habits:
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Smoking and tobacco use are linked to preterm labor, retarded intrauterine growth, low birth weight, and placental abruption. Hence, smoking cessation can lower mortality associated with pregnancy and low birth weight by 20 %. Both males and females should stop smoking before and during pregnancy, as secondhand smoke can also impact fertility and pregnancy outcomes.
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Alcohol use in pregnancy can cause fetal alcohol syndrome and also fertility issues. It is advisable to avoid alcohol for couples planning a pregnancy. Drinking alcohol during pregnancy can cause neuropsychologic adverse effects on the baby.
7. Obesity: It is linked with multiple pregnancy risks, including a high risk for gestational diabetes, congenital heart disorders in the baby, hypertension, and an increased risk of complicated deliveries, including cesarean section and other complications. Obesity is an independent risk factor during pregnancy, with an increased chance of developing pregnancy-associated hypertension, macrosomic infants, and insulin-dependent gestational diabetes.
8. Malnutrition: Women having malnutrition can be at risk for nutrient deficiencies that raise the risk for babies with low birth weight and preterm labor.
9. Toxin Exposure: Women and men should avoid toxic substances potentially impacting fertility, including lead, arsenic, fluoride, plastics, toluene, flame retardants, and pesticides.
10. Environmental Exposures: Pre-pregnancy assessment of the home environment, occupational hazards, and community hazards are essential to identifying and reducing potential risks before pregnancy, especially during the first three months. The assessment, including history exposure and duration, is also critical. Exposure to such toxins in the community and work environment is linked to congenital disabilities, low fertility, and fetal loss.
11. Medication Exposures: Pre-pregnancy planning includes careful evaluation of medications that men and women take before pregnancy. It Allows adequate time for the change to the less harmful drugs, and changes in the dosing lead to improvements in perinatal outcomes and avoidance of congenital disabilities and poor outcomes for the fetus.
12. Diabetes Management: Uncontrolled diabetes is linked with congenital heart defects, miscarriage, and intrauterine growth retardation. In the newborn, it can lead to hypoglycemia, hyperbilirubinemia, and respiratory distress syndrome. In the mother, it may increase the risk of hypertension, infections, and visual problems. Pre-pregnancy planning in diabetic women focuses on diabetes management and education, effective control, and weight management.
13. Infectious Diseases Management: Infections with known adverse impacts or long-term consequences in the perinatal period are hepatitis B, human immunodeficiency virus, tetanus, and MMR (measles, mumps, and rubella). Couples with a history of these infectious diseases should consult a doctor in the preconception period to effectively manage these conditions and manage medications accordingly.
Conclusion:
During pre-pregnancy planning, the doctor can perform the risk assessment. This risk assessment includes a thorough history of medical, surgical, genetic, nutrition, psychosocial, and behavioral risks. These also include screening for drug and alcohol use. The doctor can perform effective medication management and changes during the preconception period in women and men with behavioral health issues. Early pre-pregnancy counseling and intervention can reduce perinatal morbidity and mortality. The optimal goal of pre-pregnancy planning is pregnancy readiness, preconception wellness, and managing chronic health conditions and behavioral issues effectively.
