Trimester Zero: Preconception Care

Women can help to promote a healthy pregnancy and birth of a healthy infant by taking the following steps before they become pregnant¹:

Develop a plan for their reproductive life. Almost half of all pregnancies are unintended, so preparation for pregnancy may be inadequate. Increase their daily intake of folic acid (one of the B vitamins) to at least 400 micrograms. Taking 400 micrograms of folic acid daily reduces the risk for neural tube defects (spina bifida) by 70%.⁴ Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other vitamins that pregnant women and their developing fetus need.^1,5 Folic acid has been added to foods like cereals, breads and pasta. Folate, present in fruits and vegetables, is not as well absorbed as folic acid.

Make sure their immunizations are up to date. It is safe to take flu shots as well as diphtheria, tetanus and pertussis (Tdap) vaccines during pregnancy. These reduce illness and pregnancy complications.
Control diabetes and other medical conditions. Poorly controlled diabetes increases the risk of birth defects, as well as increasing the likelihood of obesity in the child.
Avoid smoking, drinking alcohol, and using drugs. Tobacco smoke and alcohol use during pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome. Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a variety of problems such as abnormal facial features, having a small head, poor coordination, poor memory, intellectual disability, and problems with the heart, kidneys, or bones.² According to one recent study supported by the NIH, these and other long-term problems can occur even with low levels of prenatal alcohol exposure.³
Attain a healthy weight. Obesity causes maternal complications as well as increasing the likelihood of childhood obesity and diabetes.
Learn about their family health history and that of their partner. Genetic testing is available for a ever increasing number of genetic diseases. There are now ways to smiling couple laying on grassprevent these illnesses from affecting the next generation.
Seek help for depression or anxiety. Psychotherapy and many psychiatric medications are safe during pregnancy, and untreated depression has a worse outcome.

Preconception and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can:

Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular exercise; and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risk for problems during pregnancy and ensure the infant’s health and development.
Controlling existing conditions, such as high blood pressure and diabetes, is important to avoid serious complications in pregnancy such as preeclampsia.
Help ensure the medications women take are safe. Certain medications, including some acne treatments6 and dietary and herbal supplements⁷, are not safe to take during pregnancy.

References

Preconception Care Work Group and the Select Panel on Preconception Care. Centers for Disease Control and Prevention. (2006). A report of the CDC/ATSDR
Fetal alcohol spectrum disorders. Centers for Disease Control and Prevention. (2011)
Persistent dose-dependent changes in brain structure in young adults with low-to-moderate alcohol exposure in utero. Eckstrand, K. L., Ding, Z., Dodge, N. C., Cowan, R. L., Jacobson, J. L., Jacobson, S. W., et al. (2012). Alcoholism: Clinical and Experimental Research, 36(11), 1892-1902. PMID: 22594302
National Center on Birth Defects and Developmental Disabilities Strategic Plan 2011–2015. PDF download Centers for Disease Control and Prevention. (2011).
Dietary supplements fact sheet: Folate. NIH Office of Dietary Supplements. (2009)
Acne treatment during pregnancy. American Pregnancy Association. (2007)
Prenatal care fact sheet. Department of Health and Human Services. (2009)