With the emerging awareness that the development of most pediatric chronic illnesses, together with the various challenges in the field of maternal health such as maternal morbidity and mortality, are attributed to preventable gestational determinants rather than genetic predisposition as historically suggested, the modification of environmental factors prior to conception is becoming increasingly apparent as means of precluding various obstetrical and fetal health problems. Hence, preconception care has been given emphasis as a new standard of care within maternal health services.
The article emphasized the importance of preconception care in terms of two main determinants—those that are required by the human body to function and develop, and those that are harmful and thus must be avoided. It highlights that the exquisitely intricate processes that direct the growth and development of fetal tissues, particularly during gestation, are highly sensitive to nutritional requirements and are vulnerable to environmental insults. Given that various nutritional deficiencies can have dramatic effects on the incidence of illness in the offspring, women of childbearing age must be educated about the required dietary or nutritional requirements that are needed to support a healthy pregnancy. For instance, it is critical to educate women planning conception and pregnancy about the adequate amounts of folate, among other vitamins, in order to prevent folate deficiency that can subsequently increase the risks of open neural tube defects, miscarriage, and Down’s syndrome.
Furthermore, maternal exposure to toxicants such as cigarette smoke, teratogenic medications, and alcohol can also have adverse consequences for gestational outcomes and to the developing fetus. Aside from these, exposures within the indoor air environment of the home, car, and workplace are something that also needs to be carefully considered, especially by those planning a pregnancy. This implies the importance of conducting education regarding the effects of these toxicants on the developing fetus to aid the potential need for modification of maternal lifestyle and other measures. For instance, education of women of childbearing age regarding toxic exposures from common airborne sources during pregnancy can guide them to conduct simple measures such as air purification techniques that can help eliminate, or at least minimize, toxic exposure and thus preclude consequent outcomes such as pediatric allergy, decreased IQ, autism, childhood cancers, and various other childhood health problems.
Recent findings also confirm that bioaccumulated toxicants in mothers from long ago, not only exposures occurring during the current pregnancy, pose a significant risk for the developing child. Hence, the importance of detecting accrued toxic compounds and clearing them from the mother’s body prior to pregnancy is also apparent as part of effective preconception care.
Indeed, the profound impact of environmental determinants on maternal reproductive health and fetal development suggests the importance of preconception care in promoting healthy pregnancy and positive pregnancy outcomes. This also suggests that health and medical professionals play an instrumental role not only in implementing antepartum, intrapartum, and postpartum care, but also in implementing preconception care.