As expecting parents, you want the best for the delicate new life developing in the womb. However, many couples are not aware that the health of both parents plays a key role before conception and throughout pregnancy. In fact, there are a handful of health checks to have before becoming a parent.
According to the American College of Obstetricians and Gynecologists, all women planning to have a child should undergo a preconception check-up. This enables your Ob/Gyn to determine whether there are issues that could negatively impact you or your baby’s health and correct these issues to optimize the outcome.
The most critical health factors for parents are:
- Diet and lifestyle
- Medical and family history
- Current medications
- Updating vaccinations
How Can You Ensure Your Diet Is Healthy?
While no particular food reduces fertility, the consequences of eating too much or too little food can undoubtedly impair a woman’s reproductive capacity. Approximately 20% of all infertility cases can be attributed to women being either overweight or underweight resulting in at least a 25% reduction in fertility.
Women who have a low body mass index (BMI) can experience ovulation dysfunction which is often associated with the very common and dangerous Female Athlete Triad of amenorrhea, bone loss, and eating disorder. With a high BMI, women are at risk for higher pregnancy complications for themselves and their baby including:
- Miscarriage and fetal distress
- Gestational diabetes and hypertension
- Preeclampsia
- Preterm delivery
- Stillbirth or early neonatal death
- Cesarean or instrumental delivery
- Shoulder dystocia
- Small-for-gestational as well as large-for-gestational-age infants
Of particular note, the Female Athlete Triad is a potentially life-threatening disorder because of the decreased caloric intake and energy deficit that result from eating disorders like anorexia and bulimia combined with bone loss and amenorrhea (lack of menstrual periods).
In men, obesity results in a hormonal disturbance causing a reduction in testosterone and sperm counts.
The Journal of the American Medical Association recently indicated that nearly 40% of American adults were obese in 2015 and 2016, a sharp increase from a decade earlier. The Mediterranean diet has been shown to increase success with IVF and was selected as the healthiest overall diet by US News & World Report.
What Vitamins and Minerals Should You Take Prior to Conception?
The American College of Obstetricians and Gynecologists states that vitamins and minerals play important roles in all body functions. A daily prenatal vitamin (PNV) and a well-rounded diet provide all the vitamins and minerals needed during pregnancy. Folic acid is a B vitamin that is vital for pregnant women. Before and during pregnancy, a woman requires a minimum of 400 micrograms of folic acid daily to help prevent major congenital disabilities of the fetal brain and spine called neural tube defects. Folic acid should be started at least three months before trying to conceive.
In addition to folic acid, during pregnancy a woman needs about double the amount of iron than non-pregnant women. This helps a mother-to-be make more blood to carry oxygen to the baby. Most prenatal vitamins provide the daily amount of iron needed (27 mg). Iron-rich foods include:
- Lean red meat
- Poultry
- Fish
- Dried beans and peas
- Iron-fortified cereals
- Prune juice
Calcium is also needed during pregnancy to build the baby’s bones and teeth. All women, including pregnant women, aged 19 years and older should receive 1,000 mg of calcium daily. Calcium food sources include milk and other dairy products, such as cheese and yogurt. For women who cannot tolerate milk, other sources include:
- Broccoli
- Dark, leafy greens
- Sardines
- Calcium supplements
Vitamin D works with calcium to help the baby’s bones and teeth develop. It also is essential for healthy skin and eyesight. All women, including those who are pregnant, need 600 international units of vitamin D per day. Good sources of vitamin D include:
- Milk fortified with vitamin D
- Fatty fish such as salmon
- Sunlight exposure also converts a chemical in the skin to vitamin D
Can Your Lifestyle Affect Your Pregnancy?
Smoking, drinking alcohol, and using drugs during pregnancy can have harmful effects on a fetus. While the full extent of damage has not been determined, alcohol use during pregnancy can result in mental retardation of the baby (“fetal alcohol syndrome”).
Tobacco
Approximately one-third of all men and women in the United States smoke cigarettes, which makes smoking responsible for 13% of female infertility. This behavior (even half of a pack per day) results in a 40 to 60% increase in infertility. Smoking (even second-hand smoke) accelerates the loss of eggs and can result in:
- Higher rates of miscarriages
- Ectopic pregnancies
- Earlier onset of menopause
- Possible genetic damage to eggs and sperm
Males who smoke can see their sperm count diminish by an average of 22% as well as experience a decrease in sperm fertilization potential.
Do Existing Medical Conditions Affect Your Pregnancy?
Unstable medical conditions such as diabetes mellitus, high blood pressure, depression, and seizure disorders can cause problems during pregnancy. Therefore, attempts at conception should be deferred until your health is optimized. Uncontrolled medical conditions can result in significant harm to both mother and baby.
Medications used to treat disease may also harm the fetus. You can verify the harmful risk of any drug by checking its pregnancy category. Categories A and B are the safest to use while categories C and D increase the risk progressively to a baby. Category X is contraindicated during pregnancy.
Can You Prevent Infections?
Vaccination (also called immunization) can prevent some infections, but some vaccines aren’t safe to use during pregnancy. It’s important to know which vaccines you may need and to get them before becoming pregnant.
The following vaccines are safe to be given during pregnancy:
- Tdap (tetanus, diphtheria, and pertussis)
- Influenza (inactivated)
The following vaccines should be avoided during pregnancy:
- MMR
- Varicella (for chicken pox)
- Influenza (live attenuated)
The following antibody levels should be checked prior to pregnancy for vaccination as needed:
- Rubella (use MMR)
- Varicella
If a pregnant woman acquires rubella (the German measles), her baby is at risk of congenital rubella syndrome with the associated risks of:
- Miscarriage
- Stillbirth
- Mental retardation
- Deafness
Varicella during pregnancy risks life-threatening pneumonia for the mother. If varicella is acquired within the week of delivery, then the baby is at risk for a rare condition known as neonatal varicella syndrome that comes with potentially life-threatening complications.
Is it Important for You and Your Partner to Share Your Family Health Histories with Your Healthcare Professional?
Absolutely. The best rule of thumb for any couple planning to start a family is: know your genes!
Some health conditions occur more often in certain families or ethnic groups. These conditions are called genetic or inherited disorders. If a close relative has a specific disease, you or your baby could be at higher risk of having it. Over 100 genetic mutations can be tested in the couple trying to conceive. If one member of the couple is a carrier (without symptoms) of a particular mutation, the baby’s risk is limited to being a carrier. However, if both partners are carriers of the same genetic mutation, the baby has a 25% risk of inheriting the disease which could possibly be life-threatening depending on the illness.
With the use of in-vitro fertilization (IVF), embryos can be screened for specific genetic diseases that either member of the couple is known to carry in order to avoid transference to the baby. Alternatively, screening can be performed early on during pregnancy.
