Preconception care is an aspect of medicine that ensures a woman is in optimal health before becoming pregnant. Although this type of care can be beneficial for healthy women and those with chronic medical conditions alike, relatively few women take advantage of it. For women who have a family history of genetic disease, suffer from certain medical conditions, or use prescription drugs it is of particular importance to obtain counseling before becoming pregnant in order to ensure the health of their babies.
Healthy women can benefit from preconception care for a number of reasons. They can receive counseling about what to expect during a pregnancy. Doctors might advise these women to begin taking folate in preparation for becoming pregnant, because it is critical that women have high levels of this vitamin in their blood during the early stages of pregnancy in order to prevent their babies from developing spinal cord defects. Many times doctors suggest that women take general measures to ensure good health, such as maintaining a normal weight, exercising regularly, eating a healthy diet, stopping smoking, and using alcohol in moderation.
Some groups of women are at an increased risk for having babies with genetic diseases, and could benefit from preconception genetic screening. For example, people of Ashkenazi Jewish descent are at risk for Tay-Sachs disease, and couples within this group are regularly tested to see if they are carriers for this disease before attempting to conceive. Many African Americans are carriers for sickle cell disease, and screening the prospective parents might be warranted in this population, especially if there is a history of family members having this disease. Caucasian couples who have family members with cystic fibrosis can also be tested to see whether their children might be at risk for this condition.
Certain known medical problems need to be addressed as part of proper preconception care in order to ensure that women with these conditions have healthy pregnancies. Women who suffer from diabetes mellitus should make sure that their blood glucose levels are well controlled before becoming pregnant. Certain autoimmune disorders such as lupus should also be managed before becoming pregnant, as sometimes these disorders can worsen after conception. Women with phenylketonuria, a rare metabolic disease that interferes with the ability to break down certain proteins, should go on a special diet before getting pregnant in order to prevent complications in their developing babies.
As part of preconception care, women can also be advised on which medications they can continue to take. Certain pharmaceutical agents are known teratogens, meaning that they can cause an increased risk of birth defects. For example, the blood thinner warfarin should be stopped before becoming pregnant, if at all possible. Women with bipolar disorder could be taking medications such as valproic acid or lithium that are also known to cause birth defects. Certain blood pressure medications should also be stopped.
