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Doctor, I’m planning on having a baby soon. What should I do now to prepare my body?
Good nutrition before conception can reduce the likelihood of an adverse pregnancy outcome. Folic acid supplementation before pregnancy can significantly reduce Neural Tube Defects (NTDs). NTDs are congenital, structural abnormalities of the brain and vertebral column.
Although grain fortification with folic acid improves the intake of all Americans, many authorities feel that the current level of fortification is inadequate to prevent NTDs. The standard diet now ingested in the United States contains 200 mcg of folic acid each day.
All women of reproductive age should take a minimum of 400 mcg of folic acid daily even if they are not planning to conceive because more than half of all pregnancies in the United States are unplanned. A patient with a previous child with NTDs or on anti-seizure medication should take 4 mg of folic acid daily.
Folic acid is considered nontoxic even at very high doses and is rapidly excreted in the urine. High levels should be achieved by taking an additional folic acid supplement - not by taking excess multivitamins. Multivitamins contain high levels of other vitamins that could harm pregnant women. Vitamin A, in particular, can cause abnormal prenatal development at high doses. Pregnant women should not take more than 5,000 IU per day of Vitamin A, the dose typically found in multivitamins.
Good health requires exercise. The current recommendation by the Centers for Disease Control and Prevention (CDC) is 30 minutes or more of accumulated, moderate exercise, preferably every day of the week.
Physiologic data suggests that exercise is beneficial in the prevention of gestational diabetes, particularly in obese women. Exercise decreases the risk of cardiovascular disease, even in obese women. A fit obese person has lower cardiovascular risks than a sedentary thin person (fitness trumps fatness).
Women with special medical conditions should consult their doctor before becoming pregnant. Hypoglycemia, or high blood sugar, before and during early pregnancy increases the risk of congenital anomalies by 4 to 10 times. Hypertensive medication could be changed before pregnancy to a proven safer alternative. However, due to a lack of data, newer medications may not be better during pregnancy.
Epileptic women should consult their neurologist to see if they are eligible to stop their medication. If they are not, then they should continue with a single medication, preferably the lowest effective dose.
Even if you are active and have no other medical problems, folic acid supplementation is a must before and during pregnancy.
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| Contact Information |
Dr. Naim S. Kassar is a board-certified OB/GYN. His practice is at 315 W. Route 66, Suite 201 in Glendora. For more information about Dr. Kassar or other fine physicians who have medical staff privileges at Foothill Presbyterian Hospital, call The Doctor Connection at 888/456-CVHP or visit The Doctor Connection on the web.
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