What is Preconception Care? Things You Need to Be Aware of Before Pregnancy

Pre Pregnancy Fertility and Pregnancy

Have you ever heard of preconception care? It’s a recent trend to encourage women who want to get pregnant to take good care of themselves before pregnancy. Just by keeping this in mind, it is said to make it easier to get pregnant and reduce the negative effects on the fetus.

We will be introducing preconception care in the next few articles.

What is preconception care?

Preconception care (PCC) means “care before conception”. The basic concept of pre-conception care is to improve health literacy, which means the knowledge, willingness, and ability to obtain accurate health information and to understand, evaluate, and use it. By improving health literacy, people can prevent disease and manage their health in their daily lives, and maintain a good quality of life throughout their lives.

In other words, pre-conception care is health care for the younger generation (women and their husbands/partners) to understand the current state of their bodies and to acquire the right knowledge and habits about health in preparation for future pregnancies and changes in their bodies. It is of utmost importance to include not only the woman but also her husband/partner in this effort.

Preconception care improves the health of women and their partners before pregnancy, enabling them to have a safe and secure pregnancy and childbirth and to plan their future life including marriage, pregnancy, childbirth, child-rearing, and work.

In addition, it will contribute to the long-term health improvement of future children, ultimately extending their healthy life expectancy. Even for those who are not yet thinking of getting pregnant, taking care of your own physical condition and developing a healthy lifestyle for the future will lead to a better life.

The following are five specific preconception care tips on tests and preparations that you should do.

I. Maintaining an appropriate body weight through a well-balanced diet and exercise.

A. Diet and nutrition
B. Skinniness
C. Obesity
D. Anemia
E. Osteoporosis.

II. Evaluation and improvement of chronic diseases.

F. Diabetes mellitus
G. Thyroid dysfunction
H. Hypertension
I. Bronchial asthma
J. Kidney disease
K. Collagen disease/antiphospholipid antibody syndrome
L. Medications

III. Periodic health checkup

M. Gynecology and cervical cancer
N. Breast check
O. Viral infections

IV. Evaluation and improvement of lifestyle

P. Basal body temperature chart
Q. Mind
R. Exercise
S. Partner
T. Quitting smoking and moderating alcohol intake
U. Alcohol
V.Tobacco

 Maintaining a proper weight through a balanced diet and exercise

A. Diet and nutrition

The nutritional status of the mother’s body is closely related to the intrauterine environment. It is very important to maintain a good nutritional status in preparation for pregnancy.

You should start taking folic acid from the day you start thinking about getting pregnant. Folic acid is a type of B vitamin that is essential for the normal development of the baby in the early stages of pregnancy when active cell division takes place.

It has been shown that folic acid intake prior to pregnancy can prevent 50-70% of neural tube defects, the most common congenital abnormality that occurs in early pregnancy. The Ministry of Health, Labor and Welfare recommend that “women who are planning to become pregnant should take 400μg of folic acid per day as a supplement in addition to their diet from at least one month prior to conception up to three months of pregnancy”.

Folic acid is abundant in dark green vegetables such as spinach, edamame, broccoli, seaweed, and soy products. In addition to folic acid, protein, iron, calcium, and vitamin D should be taken in a balanced manner.

A “well-balanced diet” is a diet that contains the right amount of energy and nutrients. The Ministry of Health, Labor, and Welfare has established standards for each age group and gender, and these standards are called the Dietary Intake Standards for Japanese. It is easy to maintain this balance with “one soup and three vegetables as side dishes,” so it is important not to miss it at every meal.

Iron should be consumed well before pregnancy to compensate for the loss of menstrual blood and to prepare for the increased demand during pregnancy. Calcium is an important nutrient for building the baby’s bones. Vitamin D is expected to promote calcium absorption from the intestines, strengthen bones, and boost immunity. Consciously consuming foods rich in vitamin D on a daily basis will help boost your immune system.

It also helps to regulate the environment of the endometrium, so it is one of the nutrients that people who wish to become pregnant should actively take. It is found in salmon and dried shiitake mushrooms, but it can also be synthesized in the body through exposure to ultraviolet rays. So, it is a good idea to take moderate sunbathing.

B. Skinniness

Skinniness is defined as a BMI [body mass index weight (kg)/height (m)²] of less than 18.5. The female body is controlled by hormones (gonadotropin-releasing hormone) secreted from the hypothalamus of the brain, and the menstrual cycle, including follicle development, maturation, and ovulation, is carried out normally.

Weight loss due to excessive dieting causes a decrease in the secretion of this hormone, resulting in amenorrhea and abnormal menstruation, which is said to be the cause of infertility. If you are thinking of getting pregnant, aim for a proper BMI (18.5-24.9). Pre-pregnancy skinniness s is known to increase the risk of impending premature birth, premature labor, and low birth weight babies.

A mother’s nutritional status can also affect the size of her baby. Chronic undernutrition before pregnancy and low nutrition during pregnancy can put the baby at risk for lifestyle-related diseases in the future.

When a baby is undernourished or stunted in the womb, genes are expressed that cause the body to store nutrients so that the limited nutrients can be used efficiently. This gene continues to function after birth, resulting in a body that is prone to fat accumulation.

It has been reported that when these genetic factors are added to environmental factors such as dietary habits after birth, the possibility of developing lifestyle-related diseases such as diabetes and hypertension, as well as obesity, increases.

 C. Obesity

Obesity is defined as a BMI (body mass index weight (kg)/height (m)²) of 25 or more. A menstrual abnormality related to obesity is polycystic ovary syndrome (PCOS). It is characterized by abnormalities in the hormone secreted by the hypothalamus (gonadotropin-releasing hormone) and high levels of luteinizing hormone (LH).

In addition to menstrual abnormalities, there may be increased insulin resistance and increased blood insulin levels. For polycystic ovary syndrome with obesity, weight loss is the first choice. As with thinness, aim for a proper BMI (less than 25) when considering pregnancy.

Obese women are more likely to develop gestational diabetes due to the physiological increase in insulin resistance caused by pregnancy, which increases the risk of complications such as gestational hypertension. It has also been reported that there is an increased risk of stillbirth, neural tube defects, and other congenital abnormalities.

 D. Anemia

Iron, as a material for hemoglobin (red blood cells), plays an important role in carrying oxygen to our bodies. The oxygen and nutrients carried by hemoglobin are used by cells to produce energy. Therefore, if you lack iron, you may experience fatigue, headache, palpitations, shortness of breath, dizziness, hair loss, brittle nails, dark circles under the eyes, and dullness. Women also lose iron through menstrual bleeding.

According to the Dietary Reference Intakes for Japanese (FY2020) of the Ministry of Health, Labor and Welfare, the amount of iron needed by adult women per day is 10.5 mg. When a woman becomes pregnant, the amount of iron needed increases, with an additional 2.5 mg in the early stages of pregnancy and 9.5 mg in the middle and late stages of pregnancy, about twice as much as before pregnancy. The storage of iron in the mother’s body is greatly reduced during pregnancy, and anemia is easily accelerated. Therefore, it is important to build a body that does not become anemic before pregnancy.

There are two types of iron: heme iron, which is found in animal products, and non-heme iron, which is found in plant products. The absorption rate of heme iron is 25%, while that of non-heme iron is 2-5%.

Heme iron is found in liver, beef, and bluefish. Vitamin B12, the “hematopoietic vitamin,” is also found mainly in animal products, so actively consuming animal protein can help prevent anemia. Non-heme iron is found in dried daikon and spinach. When taken with protein and vitamin C, the absorption rate can be increased.

 E. Osteoporosis

Bone resorption refers to the destruction of old bone and bone formation refers to the creation of new bone. When bone density decreases significantly, osteoporosis is diagnosed and the risk of bone fracture increases. It is generally considered to be a disease of the elderly, but during pregnancy and breastfeeding, calcium is supplied from the mother to the baby, so there is temporary osteoporosis associated with these conditions.

In addition, estrogen, a female hormone, suppresses bone resorption. Not only after menopause but also while menstruation has stopped after childbirth, the decrease in estrogen secretion can easily lead to bone density loss. This causes a temporary decrease in bone density, but it is said to return to normal after a while after breastfeeding.

However, if a woman has been on an unreasonable diet or had an unbalanced diet in the past, her bone density will decrease. If such a woman breastfeeds after childbirth, she may suffer from postpartum osteoporosis due to the fragility of her bones. If you are thinking of getting pregnant, it is recommended that you have a bone density test to know the current condition of your bones.

Calcium is found in dairy products, soy products, and small fish. There is an ideal calcium intake ratio of calcium to magnesium (2:1). It is recommended to take small fish such as dried shrimps, which contain high amounts of magnesium as well as calcium.

Conclusion

You may think that there are many things that you need to be aware of before pregnancy, however, these are for you and your future baby. Also, this is just a part of the list and you need to check the next article as well.

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