Getting ready for baby…

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Upon the recent arrival of my new great-niece, I’m posting about preparing for pregnancy.  Since almost half of all pregnancies are unplanned, being prepared now for those of reproductive age will help achieve the best and healthiest outcomes.

Chronic illness, infection, poor nutrition, under- or over-weight and unhealthy habits (such as tobacco or substance use) all contribute to poorer pregnancy outcomes.  Many of these are under our control.  Let’s look.

Nutrition.  Folic acid, a B vitamin, plays a role in the formation of the fetus’s nervous system.  Unfortunately, by the time a woman discovers she is pregnant the developmental stage dependent on folic acid has passed.  So it’s important to have a folic acid on board if you may become pregnant.  400 mcg is the recommended amount and can be found as a supplement or in prenatal vitamins.  It occurs naturally in legumes, citrus fruits and dark green leafy vegetables as well as in fortified foods.  (Excess folic acid is lost in urine so over-supplementing is usually not a problem.)

Weight.  Underweight mothers (BMI <18.5) is associated with low birth weight babies whose survival is less robust than normal-weight babies.  Low-weight mothers are also more at risk for nutrient deficiencies and bone loss; their infants are at a greater risk for a birth defect of the abdominal wall called gastroschisis where the abdominal contents protrude outside of the body.

Overweight  (BMI 25-30) or obese (BMI >30) mothers are themselves at greater risk of high blood pressure and diabetes. These conditions can contribute to several pregnancy complications including congenital anomalies or pregnancy loss.  C-section or emergent C-section may also result, putting both mother and infant at greater risk of complications.

High blood pressure.  Pregnancy can worsen high blood pressure (hypertension) and those with chronic hypertension have higher rates of preterm birth, or complications that can lead to low birth weight babies or even fetal death.  The higher the pressure, the greater the risk; women with hypertension should work hard to control their pressure prior to and during pregnancy.

Diabetes.  Nearly 10% of reproductive age women have diabetes and 1% of pregnancies are complicated by gestational diabetes.  High blood sugar is known to cause birth defects, especially in the 1^st trimester. Screening for diabetes prior to pregnancy and regular monitoring during pregnancy improves outcomes for both mother and fetus. 

Habits.  Alcohol, tobacco, illicit drugs, marijuana all have ill effects on mother and fetus, contributing to low birth weight, neurologic deficits, birthing complications, risk of future diabetes, fetal alcohol syndrome among them.  If you are thinking of getting pregnant, think even harder of reducing any substance use or abuse.

Prevention.  Vaccinations should be up to date to protect mother and fetus: Hepatitis B, flu, MMR, Tdap and chicken pox should all be addressed.  An STD screen is also recommended to reduce transmission to the baby at birth.

Diet:  a well-balanced diet favoring vegetables, especially orange, yellow and dark green leafy vegetables, some pasteurized dairy products (or other calcium rich foods if dairy must be avoided, such as kale, broccoli and bok choy); and avoidance of processed foods.  Add a modest amount of animal products (dairy, meat) to  provide the full array of nutrients, amino acids and nutrients needed.  Certain fish (shark, swordfish, king mackerel, albacore tuna, tilefish) have higher levels of mercury which can adversely affect the fetus and should be avoided.

Women who seek prenatal care have improved pregnancy outcomes over those who don’t.  A little preventive care goes a long way to produce a healthy bundle of joy.

Be well!

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