Preconceptional Care

Even before conception the subsequent development of the unborn child and potential complications of pregnancy can be significantly influenced. Preventive action before conception should therefore be considered as soon as a woman is contemplating having a baby. Many preconception issues are relevant to all women thinking about getting pregnant, not just to those with existing risks.

General precautionary advice for all women contemplating having a baby:

  • A healthy lifestyle, especially physical activity and a healthy diet, as well as folic acid supplements to reduce the likelihood of neural tube defect (spina bifida)
  • No smoking or consumption of alcohol or other drugs
  • Medical advice with regard to medical history, side effects of any medication being taken and recommended vaccinations (especially measles and chickenpox)
  • Reduced physical and mental stress at work and at home


Early detection of risks already in existence before conception relates to the following issues:

  • women with chronic diseases such as diabetes mellitus, heart disease, hypertension, obesity, thyroid diseases, rheumatism, (vein) thrombosis, mental illness
  • women with complications in previous pregnancies, such as miscarriage, preterm delivery, pre-eclampsia
  • family history and genetic factors (on both maternal and paternal sides)


Folic acid deficiency leads to an increased risk of miscarriage and preterm birth. Many women suffer from folic acid deficiency before pregnancy. Studies have shown that a very generous supply of 800 microgrammes of folic acid from at least four weeks before conception until the twelfth week of pregnancy reduces the risk of deformities (in particular neural tube defect/spina bifida, cleft palate/hare lip, congenital heart defects) by up to 70 per cent. It is very hard, if not impossible, to cover this requirement with a normal diet. Women are consequently recommended to take folic acid supplements from the time they are contemplating having a baby until after the first twelve weeks of pregnancy - and in some cases, up until breastfeeding ceases. Most formulations contain dosages of between 400 and 600 microgrammes, as an average of 200 microgrammes can be assumed to be ingested with the normal diet.

If there are so-called hereditary diseases in the family, the risk will be clarified by a doctor. The relevant genetic counselling clinics will also help here. Where there is an increased risk of neural tube defects (spina bifida, cleft palate/hare lip) a higher dosage of folic acid is recommended. Where a family risk is present, it is important to take advantage of information and counselling services on offer and especially to discuss this with a gynaecologist.

For more information on neural tube defect (spina bifida), go to the Global Spina Bifida Organization at www.ifglobal.org


Special Thanks
EFCNI thanks BabyCare for kindly providing the information above.

For further information please visit the following websites:
BabyCare: www.baby-care.de
Erich Saling-Institute of Perinatal Medicine: www.saling-institut.de

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