From the Guidelines
Pregnancy, not prednacy, is the correct term, and it is a natural process where a fertilized egg develops into a fetus inside a woman's uterus over approximately 40 weeks. During pregnancy, regular prenatal care is essential, including taking prenatal vitamins containing folic acid (400-800 mcg daily), which helps prevent neural tube defects 1. Pregnant women should avoid alcohol, tobacco, and recreational drugs completely, as these can cause harm to the developing fetus, including miscarriage, birth defects, and other adverse outcomes 1. Medications should only be taken under medical supervision, as many can harm the developing fetus, such as isotretinoins, which can cause miscarriage and birth defects 1. A balanced diet, moderate exercise, and adequate rest are recommended to support fetal development and overall health. Common discomforts like morning sickness can often be managed with small, frequent meals and ginger supplements (250 mg four times daily). For more severe nausea and vomiting, medications like pyridoxine (vitamin B6, 10-25 mg three times daily) or doxylamine may be prescribed. Pregnancy affects every body system as it accommodates the growing fetus, with hormonal changes supporting fetal development and preparing the body for childbirth and breastfeeding. Additionally, managing pre-existing conditions, such as diabetes, hypertension, and obesity, is crucial to prevent adverse pregnancy outcomes, including gestational diabetes, pre-eclampsia, and fetal macrosomia 1. Women with pre-existing hypertension should be closely monitored, and those with gestational hypertension should be managed to prevent complications, such as pre-eclampsia and fetal growth restriction 1. Overall, a healthy lifestyle, regular prenatal care, and management of pre-existing conditions can help ensure a healthy pregnancy and reduce the risk of adverse outcomes. Key recommendations for pregnant women include:
- Taking prenatal vitamins containing folic acid (400-800 mcg daily) to prevent neural tube defects
- Avoiding alcohol, tobacco, and recreational drugs
- Managing pre-existing conditions, such as diabetes, hypertension, and obesity
- Maintaining a balanced diet and engaging in moderate exercise
- Getting adequate rest and managing stress
- Attending regular prenatal care appointments to monitor fetal development and overall health.
From the Research
Pregnancy Complications
- Gestational hypertension and preeclampsia are significant complications during pregnancy, with preeclampsia complicating 2-8% of pregnancies globally 2, 3.
- The incidence of gestational hypertension and preeclampsia can be affected by various factors, including pre-pregnancy diabetes, pre-pregnancy hypertension, and prenatal care timing 4.
- Folic acid supplementation during early pregnancy has been studied as a potential preventive measure for gestational hypertension and preeclampsia, but findings suggest that daily consumption of 400 μg folic acid alone during early pregnancy cannot prevent the occurrence of these conditions 5.
Prenatal Care
- Well-coordinated prenatal care that follows an evidence-based, informed process can result in fewer hospital admissions, improved education, greater satisfaction, and lower pregnancy-associated morbidity and mortality 6.
- Care initiated at 10 weeks or earlier can improve outcomes, and identification and treatment of periodontal disease can decrease preterm delivery risk 6.
- Women with pre-pregnancy diabetes or pre-pregnancy hypertension have increased odds of receiving early prenatal care compared to women without these conditions 4.
Risk Factors
- Advanced maternal and paternal age (35 years or older) is associated with gestational diabetes, hypertension, miscarriage, intrauterine growth restriction, aneuploidy, birth defects, and stillbirth 6.
- A prepregnancy body mass index greater than 25 kg per m2 is associated with gestational diabetes mellitus, hypertension, miscarriage, and stillbirth 6.
- Rho(D) immune globulin can decrease alloimmunization risk in RhD-negative patients carrying an RhD-positive fetus 6.