The importance of preconception care has been comprehensively discussed in the review (Genuis & Genuis, 2016). As future nurses and care providers, we should be knowledgeable and competent on communicating about proper nutrition and lifestyle, environmental health and safety, and disease management for reproductive aged women even before they get pregnant. This is particularly important because the first trimester, which is often subtle and not easily detected early on, is a critical period for fetal organ development. Preparing women of reproductive age through effective health teaching can help them make informed decisions and improve maternal health care.
The review emphasized that pregnancy-related health issues are more heavily influenced by the environment rather than genetics. This implies that there are numerous modifiable factors to promote healthy pregnancy and positive pregnancy outcomes, and these are primarily through the following: securing adequacy of gestational nutrition requirements and avoiding toxicity from substances.
First, nutrition counselling is a key component of preconception care. Women of reproductive age need to know and practice eating healthy and taking necessary supplementation to reduce the risk of illnesses for offspring and promote other positive pregnancy outcomes. For instance, avoiding common micronutrient deficiencies (i.e., Vitamin D, DHA, folate, iron, magnesium, and healthy microbiome) can prevent undesirable effects for the infant, such as in terms of bone mass and central nervous system functioning. For example, as illustrated in the review, Vitamin D deficiency has been associated with miscarriage in the first trimester, gestational diabetes, and other pregnancy complications for the mother, and impaired lung development, neurocognition, and bone strength for the offspring. As such, regular evaluation of maternal serum levels in preconception period is recommended as well as supplementation if necessary. Other nutritional measures for preconception care are limiting intake of refined sugar and avoiding unnecessary use of antibiotics to ensure optimal blood glucose control and fetal microbiota, respectively.
Another important aspect of preconception care is advising women on avoiding potentially harmful exposure to chemicals and radiation. For instance, the review noted that air pollutants, which can be present even at homes, are a major source of toxic chemicals for reproductive aged women. The authors discussed how pollutants from home furniture, personal care products, and vents of electronic equipment can increase the risk of pediatric allergy and respiratory illness, decreased IQ, and endocrine disorders among others. Exposure to food products with significant insecticide and herbicide residue and its association with increased risk for gestational diabetes, decline in children’s working memory, and childhood leukemia have also been discussed.
My key takeaway is that providing quality preconception care translates to better health outcomes for reproductive aged women, and this care is a concerted effort among the clients, health professionals, and the community at large. There are general recommendations for preconception care, but individualizing this according to the unique needs of each client is also important.
Genuis, S. J., & Genuis, R. A. (2016). Preconception care: A new standard of care within maternal health services. BioMed Research International, 2016. http://dx.doi.org/10.1155/2016/6150976