Adverse pregnancy outcomes remain a prevalent health problem. 12% of babies are born premature, 8% with low birth weight and 3% have major birth defects. 31% of women giving birth suffer pregnancy complications. Risk factors for adverse pregnancy outcomes remain prevalent among women of reproductive age group like smoking, obesity, usage of teratogenic drugs and preexisting medical conditions like diabetes, hypertension etc. Hence pre-conceptional counselling and care is very important. It involves provision of medical, behavioural and social health interventions to women and couples before conception.
Healthy lifestyle behaviour must be established in order to maintain optimum health. Check your weight regularly. These women must take nutrient rich food. Iodization of salt is very important. Stay well hydrated. They need to exercise atleast for an hour everyday. Smoking, alcoholism and substance abuse must be quit.
We need to screen for medical conditions like anaemia, diabetes, hypertension, thyroid disorder etc and treat them with safe medications, if identified. Supplementing folic acid must start 2-3 months pre conceptionally. This would help prevent neural tube defects.
We need to prepare women psychologically for pregnancy. We have to take a thorough family history to identify the risk factors for genetic conditions. Carrier screening and testing must be done. Genetic counselling and appropriate treatment of genetic conditions plays an important role.
Rubella and chicken pox are two infections which are harmful to the fetus when contacted during pregnancy. Women who are not immune to them can be offered vaccination during the pre-conceptional period. As these are live vaccines, women should be advised to not get pregnant for atleast one month post vaccination.
Healthy minds and bodies lead to healthy moms and babies.
Dr Swathi Gogineni
Consultant Obstetrician and Gynaecologist,
Apollo Cradle & Children’s Hospital,
Jubilee Hills, Hyderabad.