Preconception Counselling

This month we talk about Preconception Counselling

It is important that a woman’s health status is evaluated preconception to identify any medical problems that may worsen or complicate a pregnancy, including:

• preterm birth
• fetal growth anomalies
• birth defects
• infections of the baby
• serious complications during pregnancy and delivery
• baby’s susceptibility to develop health problems throughout life, such as obesity, high blood pressure, heart disease, diabetes, lung disease, and some forms of cancer
• problems caused by pre-existing cardiovascular disease or diabetes in the mother
• death of the mother and/or baby

Preconception counselling encourages the adoption of healthy lifestyles and supplements the preconception diet with the correct vitamins and nutrients, such as folic acid.

The following key factors are important to address, between 3 and 6 months before trying for a baby, with preconception counselling.

Healthy weight

A woman should control her diet and exercise to start her pregnancy at optimal weight.

A normal Body Mass Index (BMI) is between 18.5 and 24.9. 

In every 100 women of childbearing age worldwide: 38 are overweight or obese and 7 are underweight.  

Starting pregnancy at a healthy weight can reduce the risk of diabetes and high blood pressure during pregnancy, fetal growth anomalies, preterm birth, death in the womb, caesarean section and haemorrhage after delivery.

Folic acid

Taking folic acid no less than 3 month before getting pregnant could prevent most cases of neural tube defects, such as Spina Bifida, by up to 70%..

In every 100 women of childbearing age worldwide: only 4 have taken folic acid before getting pregnant.

Folic acid is essential for the development of the baby’s neural tube, part of the nervous system, which forms around the time a woman misses her first menstrual period.  
 

Quit smoking

If a woman can quit smoking before pregnancy, she will improve her chances of getting pregnant.

She will also reduce the risk of ectopic pregnancy, miscarriage, birth defects, death in the womb, placental abruption, low birth weight and preterm birth.

In every 100 women of childbearing age worldwide: more than 30 smoke
 

Undernutrition and anaemia

Maternal undernutrition and iron- deficiency anaemia cause at least one maternal death out of five.  

Find out more about adolescent, preconception and maternal nutrition.
 

Alcohol and drugs

Severe problems for the baby from alcohol consumption include the Fetal Alcohol Syndrome.

Drug exposure, including prescription pain killers, in pregnancy may provoke Neonatal Abstinence Syndrome and risk of Sudden Infant Death.

Addiction to alcohol, cannabis and opioids may lead to miscarriages, birth defects, intrauterine growth restriction, preterm birth, admission to the neonatal intensive care unit.

There is also an association between these substances and poor growth of the baby after birth and behaviour problems.