Most birth defects happen before a woman even knows she is pregnant. Remember that about half of all pregnancies are unplanned - therefore, every woman should: Know her family history and that of her partner. Take a multivitamin that has 400 milligrams of folic acid before conception. In fact, it is best for all women in reproductive age to take folic acid. Have regular medical check-ups. If a pregnancy is planned check with your doctor about: Know what to avoid at work or at home that might be harmful to a developing baby . Keep vaccinations (shots) up-to-date. Eat a balanced diet. Avoid eating raw or undercooked meat. Avoid alcohol, tobacco, and street drugs. Get prenatal care early and steadily. more ... Pregnancy Planning If a pregnancy is suspected : See your physician immediately W.Wertelecki, M.D. Updated: March 2010

Pre-conception Checklist Planning A New Baby
Ohio Health
Visit your health care provider at least once. Stop using birth control. Avoid smoking, drinking alcohol, taking street drugs. If you are taking prescription or over-the-counter drugs, tell your provider. Avoid toxic substances, chemicals, and radiation at home or at work. For Women Only ... Achieve your normal before attempting to conceive. Underweight women tend to have smaller babies ... Overweight women are more likely to develop high blood pressure or diabetes during pregnancy. Make sure to get enough of the B vitamin (folic acid) on a daily basis. Suggested dosage for a non-pregnant women is 0.4 mg.; and for a pregnant woman is 0.8 - 1.0 mg ...

Recommendations to Improve Preconception Health and Health Care --- United States
CDC, April 21, 2006 / 55(RR06);1-23
... provides recommendations to improve both preconception health and care ... to improve the health of women and couples, before conception of a first or subsequent pregnancy ... CDC has developed these recommendations based on a review of published research ... The 10 recommendations ... are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes. ...

Preconception Health Care
March of Dimes, July 2008
Preconception health care is care a woman of childbearing age receives before pregnancy or between pregnancies. ... All women of childbearing age can take steps before they get pregnant to improve their chances of having a healthy, full-term baby. More and more babies are born prematurely (before 37 completed weeks of pregnancy), which increases the risk for serious health problems ... A preconception checkup can help assure that a woman is as healthy as possible before she conceives ...

Preconception Health Care
Stephanie C. Brundage, M.D., M.P.H., Greenville Hospital System, Greenville, South Carolina, June 15, 2002
preconception health care improves pregnancy outcomes ... before conception, folic acid supplements can prevent neural tube defects. Targeted genetic screening and counseling should be offered on the basis of age ... Before conception, women should be screened ... Environmental toxins such as cigarette smoke, alcohol, and street drugs, and chemicals such as solvents and pesticides should be avoided ...

Pre-Pregnancy Planning
Hartford Hospital, May 1, 2006
Take Care of Baby Before Conception ... Women should take stock of their health before trying to get pregnant ... That means quitting smoking, avoiding alcohol, making sure chronic conditions such as high blood pressure are under control, and dropping excess pounds, among other steps ...

Planned Parenthood Federation of America, Inc
Planned Parenthood Federation of America Inc, 2010.
Online source for sexual health information.

Planning Pregnancy
Columbia University College of P & S Complete Home Medical Guide
"17 pages of authoritative 'user friendly' text"
Physiologically, the optimal years for childbearing are between ages 18 and 35. Women who become pregnant in their early teens or after the age of 35 have an increased risk of pregnancy complications. After age 35, and particularly after 40, there is a greater risk of having a child with a congenital anomaly, such as Down syndrome. ... however, the risk is small and the vast majority of babies are healthy. A woman should if she is above her ideal weight, make every effort to lose weight. Genetic Counseling and Prenatal Testing: Increasingly important part of modern obstetrical care. Extra diagnostic tests are usually recommended for women who will be 35 years ...

Pre-Pregnancy Planning
UCLA Healthcare, 2007
Even before conception, a woman's health and substances to which she is exposed can significantly influence the success of a pregnancy and the health of her baby.

Think Ahead
March of Dimes Foundation, 2010
Birth Defects Information ... March of Dimes Saving babies, together ...

Pre-Pregnancy Planning
NOAH, May 8, 2007
March of Dimes Saving babies, together. All women of childbearing age can take steps even before conception to improve their chances of having a healthy baby. How Can Taking Folic Acid Help? ...

Planificación del Embarazo
NOAH, September 28, 2009
[Spanish]
Planificacion Familiar ... Cuidado Prenatal y Nacimiento ...

Pre-Pregnancy Planning
UCLA Healthcare, October 22, 2008
Your journey through pregnancy is perhaps the biggest physical change your body will ever undergo. Ideally, you should see a doctor before you get pregnant for recommendations on how to have a healthy pregnancy. This section covers nutrition, diet, and lifestyle changes you should consider at this time. ...

Pre-Pregnancy Planning At Cu
Columbia University's Health Education Program

Pre-Pregnancy Recommendations
You should stop acne medications, tranquilizers and sleeping pills. Stop using any illegal drugs. Quit smoking cigarettes Now! Decrease your caffeine intake. Decrease your alcohol consumption. Begin taking a multiple vitamin with iron. Take acetaminophen (Tylenol) if you get a fever or have pain. Rubella (German measles) is a serious threat to the health of your unborn baby.

Ask NOAH About Pregnancy: Fertility, Infertility & Surrogacy
NOAH, September 29, 2009
Fertility enhancement ... Male infertility ...

Maternal Age and Birth Outcomes: Data from New Jersey
Nancy E. Reichman and Deanna L. Pagnini, Family Planning Perspectives, Volume 29, No. 6, November/December 1997
[for Professionals mainly]
... the youngest (younger than 15) and oldest (aged 40 and older) mothers being at higher risk than 25–29-year-olds ... The multivariate analysis also showed that newborn hospitalization costs increased with maternal age among both blacks and whites ... The results indicate that teenagers younger than 15 have the highest risk of delivering a low-birth-weight infant relative to 25-29-year-olds, closely followed by mothers 40 and older ...

Diabetes Monitor : Planning a pregnancy
If a young woman with diabetes (or previous gestational diabetes) is planning a pregnancy soon, there's a list of things to do. Here's the advice I give my patients ... Tighten up your targets ... Do more blood sugars ... Plan on lots of shots ... Start telephoning ... Talk to a dietitian ...

Plan and Prepare for Pregnancy
Methodist Health Care System, 2006
See your physician several months before you plan to become pregnant to have: blood tests for Rh factor and immunity to rebella, hepatitis B, and toxoplasmosis ... a discussion about your family medical history ... a discussion about immunizations ... a discussion about any sexually transmitted diseases (STDs). Consider meeting with a genetic counselor to evaluate your risk of having a child with a birth defect if you: are over 35 ... have a family history of a genetic disorder ...

Are You Ready? Before You're Pregnant
March of Dimes, 2007
Birth Defects Information

Pregъntale a NOAH sobre el embarazo
NOAH, May 8, 2007
[Spanish]
Planificacion Familiar ... Cuidado Prenatal y Nacimiento ...

Un buen estado fнsico para los dos
March of Dimes, March 2007
[Spanish]

Folic Acid & Pregnancy
Policy Statement from the American College of Medical Genetics ...

Breast Cancer and Pregnancy
National Cancer Institute, Cancer Information Service
... Breast cancer is the most common cancer in pregnant and postpartum women ... About 1 in 3,000 pregnancies ... Cancer are typically detected at a later stage than in a nonpregnant ... To detect breast cancer, pregnant and lactating women should practice self-examination and undergo a breast examination as part of the routine prenatal examination by a doctor ... Staging of breast cancer should be modified to avoid radiation exposure to the fetus ... Nuclear scans cause fetal radiation exposure.

Smoking in Pregnancy
March of Dimes, November 2004
If all pregnant women in the U.S. stopped smoking, there would be an estimated 10% reduction in infant deaths, according to the U.S. Public Health Service ... A recent Danish study reported that women who smoke were about 30% less likely to conceive ... Women who smoke early in pregnancy double their risk of having an ectopic pregnancy ... Smokers are up to 80% more likely to suffer a miscarriage than their non-smoking counterparts ... Smoking nearly doubles a woman's risk of having a low weight baby ... Who weigh less than 5 1/2 pounds at birth ... Smoking during pregnancy may contribute to birth defects ... Increased risk of developing cleft lip and/or cleft palate ...

Alcohol Consumption Among Pregnant and Childbearing-Aged Women -- United States
Centers for Diesease Control and Prevention, MMWR 46(16);346-350 April 25 1997
… This report analyzes and compares data from the 1995 Behavioral Risk Factor Surveillance System (BRFSS) and previously reported 1991 BRFSS data for women aged 18-44 years (3), and presents the prevalence of alcohol consumption among pregnant women … A total of 33,585 women aged 18-44 years were interviewed … 4.7% of women aged 18-44 years reported being pregnant at the time of the interview. Of these, 16.3% reported any drinking during the preceding month, compared with 12.4% in 1991 … The rate of frequent drinking among pregnant women was approximately four times higher in 1995 than in 1991 (3.5% in 1995 and 0.8% in 1991, p less than 0.01) … Among all child bearing-aged women in 1995, 50.6% reported any drinking, and 12.6% reported frequent drinking …

Quй es Perinat?
Dra. Der Parsehian, May 6, 1998
[Spanish]
lista de correo interdisciplinaria de alcance internacional, moderada y creada para profesionales mйdicos pediatras, neonatologos, obstetras, bioquнmicos, farmacйuticos, asistentes sociales, psicуlogos/as, investigadores, enfermeras/os. matronas, parteras u obstйtricas... en fin, todos los que de algъn modo u otro trabajan para y por una mejor salud materno-infantil...

Can the anthrax vaccine be taken by military members who are pregnant?
I.B.I.S. Birth Defects, May 2, 2002

Y-Chromosome Microdeletion and Chromosome Analysis
GeneCare, May 25, 2004
Approximately 5-10% of men with oligospermia and 10-15% of men with azoospermia carry a chromosome abnormality, most commonly of the sex chromosomes. Most men with Klinefelter syndrome go undetected until trying to conceive children, when an evaluation for infertility is preformed. A chromosome analysis should be routinely offered to all men with infertility before proceeding with ICSI.

Mutation on Y Chromosome Stops Sperm Production
Howard Hughes Medical Institute (HHMI), 2010
... investigator David Page has found the first mutation on the Y chromosome that prevents sperm production and thus causes male infertility ...

Genetics of male infertility
A significant proportion of infertile male with azoospermia and severe oligospermia have a genetic etiology for reproductive failure. Cystic Fibrosis (CF) gene mutation have been detected in men with congenital absence of the vas deferens, but with no other manifestation of CF. Genetic studies revealed that 50-83% of patients with Congenital Bilateral Absence of the Vas Deferens (CBAVD) have at least one known CFTR gene mutation and that approximately 10% have two known CFTR mutations. Renal agenesis was found in 11% of patients with CBAVD and 26% of patients with CUAVD. The most common karyotype abnormality in men with severe male factor infertility is Klinefelter's syndrome, affecting 7-13% of azoospermic men ... deletion of distal end of the long arm of the Y chromosome. This region includes the azoospermia factor (AZF) locus, which contains a gene or genes, required for spermatogensis ... Microdeletions in the Y-chromosome were found in 7% of unselected group of infertile men which suggests that Y-chromosome microdeletions constitute the second most common specific cause of male infertility.

Male Infertility
Male infertility is not the same as impotence, which is the inability to have an erection. Only half of couples who are trying to become pregnant achieve pregnancy easily ... half because of male infertility. Known causes of male infertility include: 1. Genetic or inherited disease 2. Alcohol 3. Physical injury to the testicles 4. Varicose veins in the scrotum 5. Side effects of serious illness such as colitis, hepatitis, uremia, and cancer ...

Female Infertility
Infertility is the inability of a sexually active couple, not using any contraception, to conceive during one year, the time in which about 90 percent of couples succeed. Just over half of all infertility is attributable to the female partner.

Pregnancy loss
March of Dimes, 2010
...Miscarriage is pregnancy loss that occurs before 20 weeks, before the fetus is able to survive outside the womb. Most miscarriages occur in the first trimester or 12 weeks of pregnancy. As many as 50 percent of all pregnancies may end in miscarriage, because many losses occur before a woman realizes she is pregnant....

Adolescent Pregnancy
American Academy of Pediatrics, July 1, 2005
Adolescent pregnancy in the United States continues to be a complex and perplexing issue for families, health care professionals, educators, government officials, and youth themselves. The percentage of American adolescents who are sexually active has increased significantly in recent years .Currently, 56% of girls and 73% of boys have had sexual intercourse before 18 years of age. There are several predictors of sexual intercourse during the early adolescent years, including early pubertal development, a history of sexual abuse, poverty, the lack of attentive and nurturing parents ...

Teenage Pregnancy Fact Sheet
March of Dimes, November 2009

Pregnancy After Age 35
March of Dimes, 2010
... Most women over age 35 have healthy pregnancies and healthy babies. However, recent studies suggest that women who postpone childbearing do face some special risks. Since the late 1970s, birth rates for women in their late 30s and 40s have increased dramatically. According to the National Center for Health Statistics, between 1978 and 1997, the birth rate rose 90 percent for women age 35 to 39. Between 1981 and 1997, the rate increased 87 percent for women in their 40s ... How much does age affect fertility? ... have some decrease in fertility ... How do preexisting health problems affect pregnancy? ... At any age, a woman should consult her health care provider before attempting to conceive ... A 1996 Mount Sinai study found that women age 40 and older were almost three times as likely to develop diabetes, and almost twice as likely to develop high blood pressure as women in their 20s ... What is the risk of birth defects in babies of women over 35? ... The risk of bearing a child with certain chromosomal disorders increases as a woman ages ... At age 25, a woman has a 1-in-1250 chance of having a baby with Down syndrome; at age 30, a 1-in-952 chance; at age 35, a 1-in-378 chance; at age 40, a 1-in-106 chance; and at 45, a 1-in-30 chance ... What is the risk of miscarriage as a woman gets older? ... Most miscarriages occur in the first trimester for women of all ages. The rate of miscarriage in older women is significantly greater than that in younger women. Studies estimate that this risk is about 12 to 15 percent of recognized pregnancies for women in their 20s and rises to about 25 percent at age 40 ... Does the risk of pregnancy complications and adverse pregnancy outcomes increase after age 35? ... While women in their late 30s and 40s are very likely to have a healthy baby, they do face more complications along the way ... Do women over 35 have more problems in labor and delivery? ... First-time mothers over 35 are more likely than women in their 20s to have difficulties in labor ... How can a pregnant woman reduce her risks? ... Take a multivitamin containing 400 micrograms of the B vitamin folic acid daily before and early in pregnancy to help prevent certain birth defects of the brain and spinal cord. (This applies to all women of childbearing age.) ... Have a pre-pregnancy medical check-up and obtain early and regular pre-natal care during pregnancy ... Don’t drink alcoholic beverages ... Don’t smoke during pregnancy ...

Juvenile Diabetes Foundation International
The Diabetes Research Foundation ...

American Diabetes Association

Diabetes Monitor : Planning a pregnancy
If a young woman with diabetes (or previous gestational diabetes) is planning a pregnancy soon, there's a list of things to do. Here's the advice I give my patients ... Tighten up your targets ... Do more blood sugars ... Plan on lots of shots ... Start telephoning ... Talk to a dietitian ...

Guide to Type 1 (Insulin-dependent) Diabetes
Pregnancy and Contraception ...

Gestational Diabetes: Nutrition and Questions
Women with gd are often given a plan as if it is "The Ten commandments" written in stone, and are shocked when they compare their plan with others' and see some of the differences. The similarities generally outweigh the differences ...

Intolerancia de Rh
[Spanish]
La intolerancia de Rh de los neonatos ocurre cuando existe una falta de compatibilidad entre la sangre de la madre y la de su feto ... La mayorнa de la gente tiene sangre de factor Rh-Positivo ... Esto significa que producen el factor Rh, una proteina hereditaria que se encuentra en la superficie de sus glуbulos rojos. Alrededor del 15 por ciento de los individuos de raza blanca y el 7 por ciento de los de raza afroamericana carecen del factor Rh y son considerados Rh-negativos ...

Breast Cancer and Pregnancy
National Cancer Institute, Cancer Information Service
Breast cancer is the most common cancer in pregnant and postpartum women ... About 1 in 3,000 pregnancies ... Cancer are typically detected at a later stage than in a nonpregnant ... To detect breast cancer, pregnant and lactating women should practice self-examination and undergo a breast examination as part of the routine prenatal examination by a doctor ... Staging of breast cancer should be modified to avoid radiation exposure to the fetus ... Nuclear scans cause fetal radiation exposure.

Welcome to the Pregnant with Cancer Support Group
Hope for Two, 2010 .

If you Smoke While You Are Pregnanat
March for Dimes, February 2009
Smoking harms your baby. When you smoke, your baby gets less oxygen. Lack of oxygen can cause your baby to grow more slowly and gain less weight in the womb.

Smoking in Pregnancy
March of Dimes, April 2008
If all pregnant women in the U.S. stopped smoking, there would be an estimated 10% reduction in infant deaths, according to the U.S. Public Health Service ... A recent Danish study reported that women who smoke were about 30% less likely to conceive ... Women who smoke early in pregnancy double their risk of having an ectopic pregnancy ... Smokers are up to 80% more likely to suffer a miscarriage than their non-smoking counterparts ... Smoking nearly doubles a woman's risk of having a low weight baby ... Who weigh less than 5 1/2 pounds at birth ... Smoking during pregnancy may contribute to birth defects ... Increased risk of developing cleft lip and/or cleft palate ...

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Last Updated: 2010/03/10

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