Preconception Care
Article26. 08. 2019
Preconception care can be defined as a set of biomedical, behavioural and social health interventions undertaken by both the male and female before conception. It is aimed at optimising the pregnancy through ensuring the healthiest sperm and egg cells, and preparing the female body for maternity to have the best chances at a trouble-free pregnancy.
The first trimester of pregnancy (up to the 12th week) is of key importance for the successful development of the foetus. Care provision during pre-conception and early post-conception in the first trimester of pregnancy (the first three months) is called periconceptional care. Both of these periods are inextricably linked and affect the development of the foetus and the quality of pregnancy.
The quality of healthy foetal development and the course of pregnancy is decided long before the woman conceives. Periconceptual care should therefore (as the name suggests) start before conception, which isn’t an easy task as it requires the cooperation of both the woman planning pregnancy, and her gynecologist. A part of the preconception examination that is crucial, is the ability to plan and schedule a gynecological examination during the first trimester. Otherwise, there is a chance that it will be too late for certain procedures, such as ultrasound and biochemical screening for birth defects in the first trimester.
Factors affecting conception:
Modifiable:
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Nutritional status
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Employment type
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Environment and lifestyle
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Vaccination
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Long-term treatment
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Current medical condition
Non-modifiable:
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Maternal age
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Genetic, reproductive and personal medical history
Identifying the non-modifiable factors means that there are some measures that can be taken to increase the chances at sufficient fetal development and a positive pregnancy. A common and futile issue is an undiagnosed cervical lesion that goes unnoticed before pregnancy, and then requires a surgical intervention during pregnancy. In the time period preconception, these risk factors that could have a negative impact on pregnancy can be identified and addressed, such as high risk for developing a viral infection, or having bad lifestyle habits (smoking, drinking, etc.).
Pregnancy changes the normal physiology of a woman, but it also has an impact on the mothers nutritional needs. The requirement for most nutrients is increased, especially for vitamins and minerals. The energy demand however remains almost unchanged, it’s requirements increasing by a mere 300kcal, whereas with some minerals and vitamins the requirement increases by almost 100%. It is therefore quite important to consider the nutritional composition of a woman’s diet during pregnancy, to ensure that she has adequate nutrients to maintain herself as well as the baby, but also to prevent excessive weight gain. At present, it has been proved that good maternal nutrition reduces the incidence of preterm labor, increases average birth rate, and promotes healthy breastfeeding. The quantity and quality of nutrition has impacts on the course of the pregnancy.