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Preconception Care: A guide for optimizing pregnancy …

PreconceptionCareA guide for optimizing pregnancy outcomesThe American College of Obstetricians and Gynecologists, District II/NYThe American College of Obstetricians and Gynecologists recommend that all health encounters during a woman s reproductive years, particularly those that are a part of Preconception care, should include counseling on appropriate health behaviors to optimize pregnancy outcomes and prevent maternal mortality. CheCklIsT Of Preconception CAre TOpICs:education: Smoking, alcohol abuse and other drug use Folic acid supplementation, 400 mcg daily as a standard of careCounseling: Sexually transmitted infections including HIV Family planning and pregnancy spacing Healthy body weight and diet Importance of oral health Increased risk of hepatitis C in those with tattoos and/or body piercings Lead and other environmental and/or occupational exposures Genetic disorders (including cystic fibrosis and sickle cell genotypes)Assessment: Physical assessment including physical examination and medical and family history Carrier screening (racial/ethnic background/family history) Immunization record including rubella, hepatitis B, and varicella Complications with past pregnancies (postpartum hemorrhage, thrombotic event, preeclampsia/eclampsia, PIH, gestational diabetes, Rh incompatibility, etc.)

with diabetes given their increased risk of neural tube defects. Higher doses of folic acid may be beneficial in some cases, especially in the presence of other risk factors for neural tube defects. 10 3. Heart Disease: Women of reproductive age living with heart disease should be counseled about the potential risks associated with pregnancy.

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