Continued improvements in the infant and maternal mortality rates will depend on interventions before a woman becomes pregnant, according to officials from the March of Dimes, the U.S. Centers for Disease Control and Prevention and other experts.
Since nearly half of all pregnancies are unintended, the preconception period - the time before a woman becomes pregnant - is crucial to reducing many of the risks of birth defects and premature birth. Every visit to the doctor for women of childbearing age should be considered an opportunity to discuss reproductive health, the experts wrote.
Nearly 85 percent of women receive early prenatal care, which has contributed to the improvements in maternal and infant health. But, continued progress in reducing the infant and maternal mortality rates and preventing premature birth and low birth weight babies has slowed in recent years; the focus must now shift to the preconception period.
"We can't wait for new medical breakthroughs. We must take what we know and use it now," said Dr. Jennifer L. Howse, president of the March of Dimes, one of the co-authors. "Even early prenatal care may be too late to make a difference in some cases. Some interventions work best - and others only work - if they begin before pregnancy."
"Preconception Care for Improving Perinatal Outcomes: The Time to Act," was published online as part of a supplement of the Maternal and Child Health Journal. It contains nearly three dozen research articles on preconception care outlining areas where women and doctors can focus to improve the chance of having a health baby.
Included in the supplement are ten recommendations designed to make preconception health care part of routine medical visits so that risk factors can be identified before pregnancy, assisting doctors in offering women additional services to reduce the risk of premature birth and birth defects.
The Journal's supplement includes articles about the use of medication during pregnancy, information about physician beliefs and opinions about preconception care and their practices, genetic risks, the use of multivitamins (including folic acid) to prevent birth defects, as well as the impact obesity, depression, and chronic diseases have on pregnancy. Nearly a third of the articles were co-authored by March of Dimes experts.