Planning for a Healthy Baby

with Anna Marie Windsor, M.D., Obstetrics and Gynecology, Advanced Healthcare

Last Updated: Oct. 1, 2003

A great deal of medical research has been done on how to optimize a baby’s health. This has included research into the causes and prevention of birth defects, studies on fetal alcohol syndrome, the role of certain vitamins, and much more.

Here are some of the latest, as well as some of the tried-and-true, things women should do before and during pregnancy to ensure their health and the health of their child.

Anna Marie Windsor, M.D., Obstetrics and Gynecology, Advanced Healthcare "We recommend no alcohol during pregnancy because we do not know the threshold for fetal alcohol syndrome."

Before becoming pregnant
According to Dr. Anna Marie Windsor, an obstetrician and gynecologist with Advanced Healthcare, any woman who is at risk for pregnancy should take 0.4 mg of folic acid daily to help prevent neural tube defects, such as spinal bifida. Folic acid can be purchased on its own or as part of multivitamin. However, because too much Vitamin A can cause birth defects, it is important not to take “mega-doses” of vitamins.

Women should also be up to date on their immunizations. While most women know that rubella, or German measles, can cause serious birth defects, another dangerous illness is chicken pox. Chicken pox can be particularly virulent in pregnant women, causing maternal death as well as fetal abnormalities. “Now that there is a vaccine for it, it’s important for woman who aren’t sure they’ve had chicken pox to be tested for it and receive the vaccine if necessary,” the doctor said.

In addition, if a woman has a chronic medical condition, such as diabetes, it should be gotten under good control before pregnancy.

One thing many women do not consider is a history of depression, even depression that occurred years before. “It’s important for a woman with this to establish a relationship with a mental health provider because she is at a higher risk for post-partum depression. Also, a woman’s family needs to be aware of this risk and get help quickly, if needed. Depression that is neglected can become more difficult to treat,” Dr. Windsor said.

Know your history
Women whose families have a history of genetic problems, such as birth defects, cardiac defects or genetic diseases such as cystic fibrosis may want to consider genetic testing. “It’s one of those things we don’t require but women may want to take advantage of it if the results would matter to them,” Dr. Windsor said.

Another genetic issue is advanced maternal age, something that is more common today than in generations past. “Age is a risk factor for certain genetic defects such as Down syndrome. Again, a woman needs to consider if knowing this would make a difference before deciding whether to take the test,” she said.

Make beneficial lifestyle changes
The two most important things a woman can do to improve her health and her child’s are to quit smoking and drinking before becoming pregnant.

Other things, such as giving up caffeine may be beneficial for health but not as necessary. “I doubt that one or two servings of caffeine a day will have an adverse effect on pregnancy, even if used during pregnancy. Alcohol, however, is a different matter. We recommend no alcohol during pregnancy because we do not know the threshold for fetal alcohol syndrome,” Dr. Windsor said.

Exercise is beneficial during pregnancy, and in most situations, doctors encourage it. However, the recommendation is that you continue an exercise program, not start a new one. “It’s best to establish a program before becoming pregnant. In any program, it is recommended that the woman’s heart rate stay under 140 and that women not do exercises that put a strain on the joints,” the doctor said.

Women should also see a dentist before pregnancy because there is some evidence that women who have infections in their gums may be prone to pre-term labor.

During pregnancy, get prenatal care
It’s not only important that a physician check regularly on a developing child, but also to check on the health of the mother.

Among the conditions a woman must share with her doctor are any infections she may have. The best known of these is herpes, a sexually transmitted disease which can infect the child during delivery. If a woman has herpes, a physician can prescribe a drug during the last weeks of pregnancy to suppress herpes flare-ups. The alternative is a Caesarian section to protect the health of the child.

Another illness that needs attention is Group B strep. It is not sexually transmitted or related to hygiene. There are no symptoms and it causes no harm to anyone but the baby. Because of this, most women are given a routine test in the last weeks of pregnancy to determine if the infection is active. If so, a woman will be given antibiotics during labor.

Antibiotics and other drugs are a common concern among pregnant women, but Dr. Windsor notes that many are now approved for use during pregnancy. “For example, bladder infections need to be treated because they can cause premature labor,” she explained.

Of course, it is vitally important for any woman experiencing early contractions to consult her doctor as quickly as possible. “We can’t prevent premature labor, but we have drugs that can prevent delivery for a day or two, and others to accelerate fetal lung development,” Dr. Windsor said.

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