Can you promote a healthy pregnancy before getting pregnant?

For women who are thinking about getting pregnant, following a health care provider's advice can reduce the risk of problems during pregnancy and after birth. A health care provider can recommend ways to get the proper nutrition and avoid habits that can have lasting harmful effects on a fetus.

For example, taking a supplement containing at least 400 micrograms of folic acid before getting pregnant can reduce the risk of complications such as neural tube defects (NTDs)—abnormalities that can occur in the brain, spine, or spinal column of a developing fetus and are present at birth.1,2

A pre-pregnancy care visit with your health care provider can improve the chances of a healthy pregnancy. A health care provider will likely recommend that you do the following:

This plan includes your and your partner’s plans for the number and timing of pregnancies based on your values and life goals. Sharing your life plan with your health care provider can help address any potential problems before you conceive.2

You can reduce the chance that you will be diagnosed with gestational diabetes (high blood sugar diagnosed during pregnancy) by taking steps to improve your diet and lifestyle before you get pregnant. Gestational diabetes can increase the risk to your health as well as your infant's. In addition, pre-pregnancy exercise is also associated with lower risk for gestational diabetes, and the benefit increases with more vigorous levels of exercise.

Here are some specific dietary suggestions for women who are planning for a pregnancy:3,4,5,6

  • Increase your intake of fiber. Eating 10 more grams of fiber in the form of cereals, fruits, and vegetables is associated with 26% lower risk of gestational diabetes.18
  • Reduce consumption of sugar-sweetened cola. Women who drank five or more such beverages per week before they got pregnant were at greater risk of gestational diabetes.
  • Eat less red meat, processed meats, and animal fats and cholesterol. Eating less of these foods before pregnancy can decrease the chances of developing diabetes when you are pregnant.
  • Replace animal protein with protein from nuts to lower your risk of gestational diabetes. Studies have shown that substituting vegetable protein for animal protein before pregnancy can decrease risk of gestational diabetes by about half.

Folic acid is a B vitamin (B9). It helps produce and maintain new cells.7 This is especially important during times when the cells are dividing and growing rapidly such as infancy and pregnancy.8

The United States Public Health Service recommends that all pregnant women and “women of childbearing age [15 to 44 years] in the United States who are capable of becoming pregnant should consume [a supplement containing] 0.4 mg of folic acid per day for the purpose of reducing their risk of having a pregnancy affected with spina bifida or other NTDs.” 9

Although a related form of folic acid (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.10 Studies show that taking folic acid for 3 months before getting pregnant and for 3 months after conceiving can reduce the risk of NTDs such as spina bifida 11,12 by up to 70%.13

Ask your health care provider if you need a booster for any vaccines. Some vaccines can be given during pregnancy, but the rubella (German measles) and varicella (chicken pox) vaccines are recommended before you get pregnant.

Many health problems affect not only the pregnant woman but also the developing infant. Some examples are diabetes, hypertension (high blood pressure), infections, asthma, seizure disorders, and maternal phenylketonuria (an inherited condition in which the pregnant woman’s body can’t break down the amino acid phenylalanine [pronounced fen-l-AL-uh-neen], resulting in high levels in her blood). Getting health problems under control before and during pregnancy reduces the risk of miscarriage and stillbirth as well as other health problems for the infant.11

During pregnancy, these behaviors can increase the risk for sudden infant death syndrome (SIDS), preterm birth, fetal alcohol spectrum disorders, and NTDs.14 If you are trying to quit smoking, drinking, or doing drugs and you need help, talk to your health care provider about support groups or about medications.

Advice, tips, and support to help women quit smoking (including expecting mothers) are available through the Smokefree Women website.

Obesity may make it more difficult to become pregnant.15 Being overweight or obese also puts you at risk for complications during pregnancy, such as high blood pressure, preeclampsia, gestational diabetes, and stillbirth, and increases the chances of cesarean delivery.

NICHD researchers have found that obesity can increase your child’s risk of a congenital (pronounced kon-JEN-ih-tal) heart defect (a problem with the heart that is present at birth) by 15%.16 Research has also uncovered a link between obesity and NTDs.16

Talk to your health care provider about what a healthy weight is for you and about a plan to help you achieve it.

Your health care provider will ask for information about your family’s genetic and health history. You may be referred for genetic counseling if certain conditions run in your family or if a family member was born with a physical abnormality or an intellectual and developmental disability. 13

Good mental health means you feel good about your life and value yourself. It’s natural to worry or feel sad, anxious, or stressed at times. However, if these feelings do not go away and they interfere with your daily life, it’s important to seek help before you get pregnant.14 Hormonal changes and other situations during pregnancy can worsen depression.

Many people are familiar with the phrase “postpartum depression,” meaning depression that occurs after the birth of a baby. But we now know that it’s not just during the postpartum period, and it’s not just depression.

Women experience depression and anxiety, as well as other mental health conditions, during pregnancy and after the baby is born. These conditions can have significant effects on the health of the mother and her child. Getting mentally healthy before you get pregnant can help minimize the effects of these conditions.

Learn more about how Moms’ Mental Health Matters.

Citations

  1. NICHD.(2010). Healthy native babies: Workbook and toolkit. Retrieved May 23, 2012, from http://www1.nichd.nih.gov/publications/pubs/Documents/ healthy_native_babies_workbook.pdf (PDF 3.59 MB)
  2. Centers for Disease Control and Prevention. (2006). A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Retrieved May 18, 2012, from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5506a1.htm
  3. Zhang, C., Liu, S., Solomon, C. G., & Hu, F. B. (2006). Dietary fiber intake, dietary glycemic load, and the risk for gestational diabetes mellitus. Diabetes Care, 29(10), 2223–2230. Retrieved August 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/17003297
  4. Chen, L.,Hu, F. B., Yeung, E., Willett, W., & Zhang, C. (2009). Prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care, 32(12), 2236–2241. Retrieved August 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/19940226
  5. Zhang, C., Schulze, M. B., Solomon, C. G., & Hu, F. B. (2006). A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus. Diabetologia, 49(11), 2604–2613. Retrieved August 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/16957814
  6. Bao, W., Bowers, K., Tobias, D. K., Hu, F. B., & Zhang, C. (2013). Prepregnancy dietary protein intake, major dietary protein sources, and the risk of gestational diabetes mellitus: A prospective cohort study. Diabetes Care, 36(7), 2001–2008. Retrieved August 26, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/23378620
  7. Kamen, B. (1997). Folate and antifolate pharmacology. Seminars in Oncology, 24(5 Suppl 18), S18-30–S18-39. PMID: 9420019
  8. NIH Office of Dietary Supplements. (2016). Dietary supplement fact sheet: Folate.Retrieved July 10, 2012, from http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
  9. Centers for Disease Control. (1992). Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Recommendations and Reports,41(No. RR-14), 1–7. PMID: 1522835. Retrieved July 31, 2013, from http://www.cdc.gov/mmwr/preview/mmwrhtml/00019479.htm
  10. Food and Nutrition Board, Institute of Medicine. (1998). Dietary reference intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academy Press.
  11. American College of Obstetricians and Gynecologists (ACOG). (2005). The importance of preconception care in the continuum of women's health care [ACOG Committee Opinion].Retrieved April 12, 2012, from https://pubmed.ncbi.nlm.nih.gov/16135611/
  12. ACOG. (2015). Good health before pregnancy:Preconception care [ACOG FAQ056 Pregnancy]. Retrieved January 5, 2016, from http://www.acog.org/~/media/For%20Patients/faq056.pdf?dmc=1&ts=20130422T1153356227 external link
  13. MRC Vitamin Study Research Group. (1991). Prevention of neural tube defects: Results of the Medical Research Council Vitamin Study. Lancet, 338(8760), 131–137. PMID: 1677062 and see Centers for Disease Control and Prevention. (2011, February). National Center on Birth Defects and Developmental Disabilities strategic plan 2011–2015. Retrieved June 26, 2012, from https://www.cdc.gov/ncbddd/strategic-plan
  14. Centers for Disease Control and Prevention. (2015). Preconception care and health care: Planning for pregnancy. Retrieved January 5, 2016, from http://www.cdc.gov/preconception/planning.html
  15. Pasquali, R., Patton, L., & Gambineri, A. (2007). Obesity and infertility. Current Opinion in Endocrinology, Diabetes and Obesity, 14,482–487. PMID: 17982356
  16. NIH. (2010). Risk of newborn heart defects increases with maternal obesity [news release]. Retrieved May 19, 2012, from http://www.nichd.nih.gov/news/releases/Pages/ 040710-newborn-heart-defects.aspx
  17. Womenshealth.gov.(2009). Publications:Depression during and after pregnancy fact sheet. Retrieved June 12, 2012, from http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.html
  18. NICHD. (2014). Healthy Pre-Pregnancy Diet and Exercise May Reduce Risk of Gestational Diabetes. Retrieved May 18, 2018, from https://www.nichd.nih.gov/news/resources/spotlight/082114-pregnancy-GDM
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