Kristie McNealy, MD

Prematurity impacts 1 in 8 babies born in the US – that’s a preemie every minute!  So, for today’s installment of Blogging for Prematurity Awareness Month, I’m going to share some healthy choices you can make to help reduce your risk of having a preemie before you even become pregnant.   While there is nothing you can do to completely assure yourself a healthy, full term pregnancy, why not take a few simple steps to give yourself and your baby the best shot?

1. Visit your doctor first. Pay a visit to your gynecologist for an annual exam. The last thing you need during your pregnancy, is the added stress of an abnormal pap smear or something similar. Plus, you can use the visit to discuss your plans to start trying to conceive, and address any current health concerns or problems with previous pregnancies.  If you’re taking any prescription or over the counter medications, you should also use this visit to find out whether your medications are safe during pregnancy, or if there are better alternatives.
2. Start taking a prenatal vitamin with folic acid now. Folic acid is proven to help prevent neural tube defects like spina bifida if it is taken very early in pregnancy,before most women even know they are pregnant. In addition, recent research has shown that taking a folic acid supplement for a year before conception can reduce your risk of delivering a premature baby by 50-70%.
   
3. If you’ve had a preemie or other pregnancy complications in the past, find a perinatologist. If you have a history of premature birth, whether or not the cause is known, you’ll probably need extra monitoring from a doctor that specializes in high-risk pregnancies.  Find one that you like and feel comfortable with now, before you are pregnant.  Visit them to discuss what you should expect when you’re pregnant, or if there is anything special you can do before pregnancy to help reduce your specific risks.
4. Give your body time to recuperate. You may want your kids to be close in age, but studies show that the optimum timing between pregnancies to reduce your risk of having a low birth weight or premature baby is 18 months to 5 years.
5. Visit the dentist. There have been studies linking gum disease to an increased risk of premature birth.  Visit your dentist for a check up and cleaning before you become pregnant, and continue to have regular dental visits to keep your mouth healthy.
6. Quit smoking. Quitting smoking is hard, so give yourself enough time to make the change. Smoking during pregnancy is linked to low birth weight,and an increased risk of sudden infant death syndrome.  Drugs and alcohol are also dangerous to a developing baby, so the time to quit is now, before you are pregnant.
7. Find your healthy weight, and maintain it with a healthy diet. Both overweight and underweight women are at an increased risk for pregnancy complications. Women who are underweight have an elevated risk of having a preemie or low birth weight baby. Obese women have an increased risk of complications during both pregnancy and delivery, as well as an increased risk of high blood pressure and gestational diabetes. This is serious, because mom’s with gestational diabetes and high blood pressure both have an increased risk of having a preemie.  On top of that, their babies have a higher risk of complications after birth.
8. If you have fertility problems, consider single embryo transfer or other ways to prevent conceiving high order multiples. Being pregnant with more than one baby is a major risk factor for preterm birth.  Talk to your fertility doctor about the likelihood that you could become pregnant with more than one baby, and what can be done to reduce the risk of becoming pregnant with 3, 4 or even more.

While nothing can ever guarantee a perfectly healthy pregnancy, taking these steps before you start trying to conceive can give you and your baby both a better shot at a health and happy 9 months!