Start Care Early

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 and the U.S. Centers for Disease Control and Prevention.

female exam

Nearly half of all pregnancies are unintended, so 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, say experts.

Preconception care crucial

Nearly 85 percent of women receive early prenatal care, which has contributed to the improvements in maternal and infant health. Continued progress in reducing the infant and maternal mortality rates and preventing premature birth and low-birthweight babies has slowed in recent years, though; 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," says Dr. Jennifer L. Howse, president of the March of Dimes and one of the study's co-authors. "Even early prenatal care may be too late to make a difference in some cases. Some interventions work best (and others work only if) they begin before pregnancy."

Supplementing fetal and maternal health

"Preconception Care for Improving Perinatal Outcomes: The Time to Act" was published in 2006 as part of a supplement in the Maternal and Child Health Journal. The supplement contains nearly three dozen research articles on preconception care outlining areas on which women and doctors can focus to improve the chances of having a health baby.

Included in the supplement are 10 recommendations designed to make preconception health care part of routine medical visits so that risk factors can be identified before pregnancy. That helps doctors offer 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 physicians' beliefs and opinions about preconception care and their practices; genetic risks; the use of multivitamins (including folic acid) to prevent birth defects; and the impact of obesity, depression and chronic diseases on pregnancy. Nearly a third of the articles were co-authored by March of Dimes experts. 

More reading

Regular multivitamin use near time of conception significantly reduces preeclampsia risk
Before pregnancy: What you can do to prepare your body
If you want more babies, find a man with a deep voice

Tags: fetal health maternal health

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