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Prenatal Care for a Healthy Pregnancy

Prenatal Care for a Healthy Pregnancy

Do this for prenatal care and a healthy pregnancy.

Your prenatal care for a healthy pregnancy requires planning for these important screenings and lifestyle changes to have the best chances of a healthy baby. Your Obstetrician will assist you with the majority of the following screenings and nutritional needs during your pregnancy.

Iron in Prenatal Care for a Healthy Pregnancy

The US Preventive Services Task Force recommends screening for iron deficiency in pregnant women even without symptoms of anemia. This is best done as soon as your learn that you have become pregnant. Iron deficiency while pregnant may contribute to lower birth weight and may lead to poor mental development of the child (38). Iron supplements should be given to iron deficient pregnant women but excessive iron from supplements can be harmful (6). The iron intake requirement in prenatal care for a healthy pregnancy is 27 mg daily.

Avoid Use of Alcohol

Prenantal care for a healthy pregnancy includes abstaining from alcohol use. Your primary care or Obstetric physician will screen you especially in pregnancy for the misuse of alcohol.

Screening for Bacteruria

At a gestation of 12-16 weeks, the U.S. Preventive Services Task Force (USPSTF) recommends testing for bacteria present in the urine in pregnant women. Pregnant women have a lower risk of urinary tract infection and babies have a lower risk of low birth weight. The USPSTF states that a positive urine culture with over 100,000 colonies per ml should be given antibiotics. (45)

Prenatal Care for a Healthy Pregnancy Includes STD Screening

The U.S. Preventive Services Task Force (USPSTF) recommends that pregnant women receive STD screening as part of prenatal care for a healthy pregnancy. Pregnant women 24 years old or younger or those at high risk should be screened for chlamydia.  The same population 25 years old or younger should be screened for gonorrhea. High risk is considered by the USPSTF as history of STD (sexually transmitted disease), or have new or multiple sexual partners with inconsistent condom use whether pregnant or not. For women not at increased risk, the USPSTF recommends against routine screening for chlamydial and gonorrhea infection for all women aged 25 and older, regardless of pregnancy status. (37)

Soothe the Baby with Music

Baby monitors allow you to hear the baby’s heart beat in the womb. Some monitors play music to the baby and even sing the baby’s name in the songs.

Start Taking Folic Acid Immediately

Folic acid is the most important of all vitamins in prenantal care for a healthy pregnancy. A prenatal vitamin containing 0.8 mg of folic acid daily is necessary starting your first month of pregnancy. If any woman is able to become pregnant, the U.S. Preventive Services Task Force (USPSTF) recommends a daily supplement of folic acid at a dose of 0.4-0.8 mg per day to significantly reduce the possibility of neural tube defects (44).

Calcium for a Healthy Pregnancy

Pregnant and nursing women younger than 18 years are recommended to receive 1300 mg/day of calcium. Among pregnant and nursing women older than 18 years, 1000 mg/day of calcium is recommended.

Vitamin D and Pregnancy:

Supplementation with vitamin D is important especially during the 3rd trimester of pregnancy unless subject to adequate sun exposure. Wagner, CL et al stated that during pregnancy, the body will convert twice the normal amount of active 1,25(OH) vitamin D by the end of the first trimester, and over three times the normal amount by birth, while calcium levels remain normal. This is believed to represent a need for more vitamin D during pregnancy than at any other time, especially since the authors observed 80% of pregnant women to be well below this level. Wagner et al suggested that a daily dose of 4000 IU of vitamin D3 per day, starting at 12-16 weeks gestation, was effective in raising the mother’s 25(OH) D levels provides sufficient levels of vitamin D during pregnancy. (70)

Test for Hepatitis B:

The U.S. Preventive Services Task Force (USPSTF) states that prenatal care for a healthy pregnancy should include  testing for hepatitis B infection at the first prenatal visit (1st visit to the obstetrician after becoming pregnant) because the transmission of the virus to the baby can potentially be prevented (19).

Rh Antibody Testing in Needed in Prenatal Care for a Healthy Pregnancy

The U.S. Preventive Services Task Force (USPSTF) recommends Rh blood typing with antibody testing for the first prenatal care visit and a repeat Rh antibody test for women who are Rh negative between 24 and 28 weeks gestation only if the father is not known to be Rh negative (21). If a woman is Rh negative, the baby may develop a severe anemia related to Rh disease which may destroy fetal red blood cells. This can be prevented by giving a mother Rh immune globulin at 28 weeks (22).

Omega 3 Oil During Pregnancy

Omega 3 is vital for brain, eye, and heart development and necessary as part of prenantal care and a healthy pregnancy. Omega 3 may reduce the risk of pre-eclampsia, and promote a higher birth weight. Omega 3 is best obtained from eating cold water fish such as wild salmon, sardines, herring, mackeral, tuna, and anchovies. When unable to consume cold water fish twice weekly, a fish oil purified to eliminate mercury and PCBs is ideal. Omega 3 fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). For vegetarians, there is algae derived DHA supplements available. Judge MP et al (68) found that maternal consumption of 300 mg of DHA weekly during pregnancy during the last 3 months of pregnancy improved problem solving better than placebo by children when tested at 9 months of age. In this study, memory tasks by the 9 month olds on treatment did not perform better than placebo. Helland IB et al (69) gave pregnant mothers 1183 mg of DHA and 803 mg of EPA or a corn oil placebo from 18 weeks through 3 months after delivery. They tested their children at age 4 with an intelligence test named the Kaufman Assessment Battery for Children. The DHA/EPA group of kids scored 106.4 vs 102.3 in the corn oil group.

If You Smoke, Do What it Takes to Quit Immediately

Ensure proper prenantal care for a healthy pregnancy by quitting smoking. Use a combination of methods to assist in cessation of smoking. For instance, combine nicotine replacement with at least one additional method such as an exercise program, hypnosis, or formal counseling such as support groups. The recommendation to counsel patients to stop smoking, stop using tobacco products, and provide methods of cessation is reinforced by the U.S. Preventive Services Task Force (USPSTF) (25). Many resources are available to assist in smoking cessation such as the online sites http://smokefree.gov/, http://www.cdc.gov/tobacco/campaign/tips/quit-smoking/ and the free phone number for free help 1-800-QUIT-NOW.

Plan to be Tested for Gestational Diabetes

Gestational diabetes is the medical term used to describe diabetes mellitus that presents during pregnancy. Gestational diabetes may develop into type II diabetes after the baby has been delivered. The American Diabetes Association estimates that approximately 4% of women who are pregnant will develop gestational diabetes. This condition requires very specialized prenantal care to ensure a healthy pregnancy in order to protect the health of both the mother and child. (62)

Women who are greater risk for gestational diabetes should undergo a 5 hour glucose tolerance test (GTT) to ensure prenatal care for a healthy pregnancy. The screening test is a simple blood test that is drawn to look for the presence of too much sugar in the blood. During a five hour GTT the woman is given between 8-16 ounce of a high sugar drink and then urine and blood is tested at 30 minute intervals for the next 5 hours. This test looks at how the woman’s body handles the extra sugar load, how much insulin is secreted and how much sugar is left in the blood stream and spills into the urine.

Researchers have found that babies who suffer from gestational diabetes have negative effects in later years. Left untreated the condition causes complications during the delivery and for the mother which will compromise prenatal care. For these reasons it is very important to identify and treat gestational diabetes as early as possible.

Chocolate Consumption as Part of Prenatal Care for a Healthy pregnancy :

Consider eating chocolate as part of prenatal care for a healthy pregnancy. Chocolate consumption may help prevent pre-eclampsia, Researchers looked at 2,291 women who delivered a single infant, and asked them about how much chocolate they consumed in their first and third trimesters. The researchers also tested levels of theobromine, used as a biomarker for chocolate consumption, in infants’ umbilical cord blood. Women who consumed the most chocolate and those whose infants had the highest concentration of theobromine in their cord blood were the least likely to develop pre-eclampsia. Women in the highest quarter for cord blood theobromine were less likely to develop the complication than those in the lowest quarter. Women who ate five or more servings of chocolate each week in their third trimester of pregnancy were 40% less likely to develop pre-eclampsia than those who ate chocolate less than once a week. A similar, but weaker, relationship between chocolate consumption and pre-eclampsia risk was seen in the first trimester, with women eating five or more servings of chocolate each week at 19% lower risk than those who ate chocolate less than once a week. (56)

Researchers examined whether regular chocolate consumption during pregnancy is associated with reduced risks of pre-eclampsia and gestational hypertension. A total of 2,508 women were included in this study. A higher chocolate intake in the first or third trimester was associated with a lower risk of pre-eclampsia and in the first three months of pregnancy. Of those who developed pre-eclampsia, 37.5% did not consume chocolate regularly. Women who reported regular chocolate consumption had a 45% lower risk of pre-eclampsia during the first trimester. (57)

Yoga During Prenatal Care for a Healthy Pregnancy

Narendran S. et al (58) noted that regular yoga exercise was shown to have beneficial effects in a study of 335 women who were between 18 and 20 weeks of pregnancy. The yoga group (n=169) practiced for an hour per day, and the control group (n=166) walked 30 minutes twice a day. Both groups practiced every day from the time they enrolled in the study to when they gave birth. The women who practiced yoga had babies with higher birth weights of 2,500 grams or more. Additonally, yogs resulted in lower rates of preterm labor, less intrauterine growth retardation (IUGR), and less pregnancy induced hypertension.

Another study by Rakhshani. A et al (59) showed significantly fewer pregnancies with induced hypertension, preeclampsia, gestational diabetes, and intrauterine growth restriction (IUGR) cases in the yoga group. There were also significantly fewer Small for Gestational Age (SGA) babies and less newborns with low APGAR scores in the yoga group.

Dangers of Meats with Preservatives and Nitrates in Pregnancy

Preston-Martin S. et al (60) found that consumption of certain meats either by the pregnant mother, or by the child may result in an increased risk of childhood cancers. Researchers found an increased brain tumor risk in offspring of mothers with relatively high consumption levels of nitrite from cured meats during their pregnancies compared to not eating these meats. The study suggested that exposure to N-nitroso compounds, found in cured meats, during pregnancy may be associated with brain tumors in children. Sarasua S. et al (61) found that children whose mothers consumed one or more hot dogs per week during pregnancy had twice the normal risk of developing brain tumors. This study suggests that pregnant women should minimize consumption of hot dogs and other processed meats such as bologna, sausage, pepperoni and other packaged luncheon meats out of their diets. Consider avoiding these foods in prenatal care for a healthy pregnancy.

Include Probiotics in Prenatal Care for a Healthy Pregnancy

Atopic dermatitis (eczema) is a long-term (chronic) skin disorder that involves scaly and itchy rashes that is the most common allergy in babies and small children. In a review, researchers looked for trials testing whether or not probiotic supplements use during pregnancy and early life can prevent this type of dermatitis in infants and young children. Probiotics are “friendly bacteria” naturally found in yogurt. Probiotic tablets or liquid supplements can be used by pregnant women or by babies. The reviewers found 14 studies, mostly done between 2007 and 2011. They found a roughly 20% reduction in the rate of atopic dermatitis ((RR = 0.79). The results suggested that probiotics have a moderate role in the prevention of atopic dermatitis. It does not appear to matter at what time the probiotics are consumed (pregnancy or early life) nor who consumed them – child, mother or both. (66)

Iodine Requirement in Prenantal Care for a Healthy Pregnancy

Iodine requirements in prenatal care may affect the intelligence in children. The USDA recommends 220 mcg of iodine daily for pregnant mothers, and 290 mcg daily for lactating mothers. Iodine deficiency was found to reduce intelligence in infants and children and thus is of critical importance during  pregnancy (67).

Plan to Breast Feed as Part of Prenatal Care for a Healthy Pregnancy

Breast feeding an infant once they are born is highly recommended and supported by the U.S. Preventive Services Task Force (USPSTF) instead of using formula or cow’s milk. Prepare for breastfeeding early in pregnancy by purchasing the necessary equipment. Pump breast milk to provide breast milk to the infant when the mother cannot be with the baby. When breast milk cannot be used for any reason, use a formula with hydrolyzed whey. Look here to find out why: Baby Formula, Breast Feeding, and Nutrition.

References: Prenatal Care for a Healthy Pregnancy
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