It is really encouraging that I now see lots of patients in the pre-conception stage. We have a long chat about trying to conceive, healthy lifestyles, and how they feel about becoming parents overall. I think it’s a great opportunity to build a relationship with a GP who will look after you throughout pregnancy and beyond – including helping you with postnatal problems and becoming your baby’s GP.
When I looked up a Cochrane review on routine pre-pregnancy health promotion, however, I was disappointed with the conclusions that “there is little evidence on the effects of pre-pregnancy health promotion” on pregnancy outcomes. Was I doing all this pre-conception counseling in vain?
A more recent study of over 5000 women was more encouraging. The researchers identified the factors that led to a decreased risk of a complicated pregnancy. That is, what makes for a healthy pregnancy – one without complications like diabetes, poor fetal growth, prematurity etc. The factors that lead to an uncomplicated pregnancy are:
- not being overweight (BMI < 25)
- not taking recreational drugs
- no alcohol while pregnant
- normal blood pressure
- pre-pregnancy fruit intake of at least 3 pieces daily.
Interestingly, maternal age was not associated with increased risks in pregnancy, despite the current thinking.
Perhaps the problem is not that health promotion is not useful, but it currently isn’t effective in normalizing these risk factors – such as weight and diet. In particular, advice on how to lose weight is vague and not evidence-based.
However, planning a pregnancy can be a powerful motivator for change. Not only will a healthier lifestyle improve chances of falling pregnant and having a healthy pregnancy, but parents can begin to set good examples for their children to follow.
Photo credit: http://www.dailyhiit.com/hiit-blog/hiit-diet/diet-tips/youre-dieting-wrong/
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