While the ideal outcome of a pregnancy cannot be guaranteed, there is much that both parents and physicians can do when planning a pregnancy to minimize so-called modifiable risks, those risks that we can control..

Motherisk Canada experts talk about these risks and situations during pregnancy.

The risks include:.

• Optimization of the diet of the expectant mother.

• Maintenance of normal body weight.

• Regular exercise.

• Stop smoking, alcohol and drugs.

• Careful control of chronic diseases.

• Taking a multivitamin with folic acid.

• Proper mode of work and rest.

• Timely immunization.

In a healthy young woman, the risk of a poor pregnancy outcome is generally very low, but when planning a pregnancy, it will never be superfluous to exclude various biomedical, behavioral, social risks - this will positively affect the health of the mother and child.

Maintaining a Healthy Lifestyle During Pregnancy.

Ideally, a woman should lead a healthy lifestyle all the time, and not just after the decision to have children.. Numerous scientific works by American, Canadian and European researchers show that a balanced diet, daily exercise, giving up bad habits, avoiding work with toxic substances and reducing stress minimize the risk of having children with pathologies..

Exercises.

Daily aerobic exercise for 30-60 minutes helps maintain a normal respiratory and cardiovascular system, improves overall fitness and helps a woman prepare for the physical changes during pregnancy..

Exercise can also improve mental health and reduce stress by boosting endorphins and lowering cortisol levels (Rimmele U. , Celier R. , 2008).

Smoking.

Smoking is associated with reduced fertility and poor pregnancy outcomes, including miscarriage, preterm birth, and low birth weight (American Society for Reproductive Medicine, 2012). Moreover, smoking is associated with an increased risk of sudden infant death syndrome (Mitchell R. , Elerad J. , 2006). Even 5 years ago, the link between smoking and the birth of children with cleft palate was proven (Lie R. , Wilcox A. , 2008).

These effects are considered dose dependent.. Women who smoke more than 10 cigarettes a day put their offspring at greatest risk. Since smoking is a modifiable factor, a woman should discuss treatment for nicotine addiction with her doctor before considering pregnancy..

Alcohol.

The impact of alcohol on the fetus not only negatively affects the outcome of pregnancy, but can also lead to the development of a whole range of alcohol-related disorders in children: growth retardation, facial deformity, microcephaly, mental retardation, behavioral disorders (Pruett D. , Waterman E. , 2013).

The effect of alcohol on the fetus is also dose-dependent: drinking more than 10 grams of alcohol per day significantly increases the risk of fetal growth retardation, low birth weight, and preterm birth (Patra J. , Bakker R. , 2011).

Although infrequent and moderate drinking has not been associated with severe fetal outcomes in many studies, the methodological weaknesses of these studies cast doubt on their findings.. Most experts today are of the opinion that there is no “guaranteed safe” amount of alcohol for a pregnant woman..

drugs.

The use of drugs by a pregnant woman can affect both the health of the mother herself and the health of the child.. Studies show that among pregnant drug addicts there is an increased risk of sexually transmitted diseases, placental abruption, fetal growth retardation, neonatal withdrawal syndrome in the newborn, congenital malformations (Shankaran S. , Lester B. , 2007).

Cocaine, in particular, is associated with an increase in the risk of preterm birth by an average of 3.4 times, the birth of children with low birth weight by 3.7 times, mismatch between the size of the fetus and gestational age by 3.2 times (Gouin K. , Murphy K. , 2011).

toxins.

Numerous environmental toxins such as heavy metals, organic solvents, pesticides may increase the risk of low birth weight, intrauterine growth retardation, preterm birth, and congenital malformations..

Complete cessation of exposure to harmful substances for modern people may simply be impossible, but activities and situations that increase the risk should be avoided..

For example, women who consume very large amounts of marine fish should be aware that it may contain methylmercury, an organometallic compound that can negatively affect fetal brain development (Koren G. , 2010). In Western countries, in order to avoid such situations, it is even practiced to measure the concentration of mercury in the blood of women planning to become pregnant..

Psychological stress.

In recent years, more and more evidence has accumulated that psychological stress negatively affects pregnancy outcomes.. The maternal biological response to stress, which is manifested by elevated levels of cortisol and catecholamines, can interfere with normal fetal development, preterm birth, and other complications (Hobel C. , Goldstein A. , 2008).

Thus, it is very important for women with pre-existing psychological or psychiatric problems to seek specialist advice before planning a pregnancy, even if they think the problem is under control..

chronic diseases.

Often, women think about having children over the age of 30, many already have certain chronic diseases: diabetes, rheumatoid arthritis, epilepsy, hypertension, etc..

Uncontrolled illness in the mother is associated with a poor pregnancy outcome, so it is very important to consult your doctor before planning a pregnancy, choose medications that are safe for the fetus, etc..

Women who have experienced severe symptoms of toxemia are more likely to suffer from such problems in their next pregnancies.. Safe treatment options for pregnant vomiting should be discussed with your doctor beforehand..

healthy weight.

Obesity is a factor that reduces fertility and prolongs pregnancy (Ramlau-Hansen C. , 2007). Obesity during pregnancy is associated with numerous complications: miscarriage, hypertension, preeclampsia, gestational diabetes, deep vein thrombosis, need for caesarean section (Furbar C. , McGowan L. , 2013).

On the one hand, obese women are more likely to have children with macrosomia and congenital malformations such as neural tube defects.. At the same time, underweight women have an increased risk of intrauterine growth retardation..

Multivitamins.

Folic acid in combination with other vitamins, taken before conception and during pregnancy, reduces the risk of neural tube defects and other fetal malformations (Goh Y. , Bollano E. , 2006).

To this end, every day a pregnant woman should receive at least 400 mcg (0.4 mg) of folic acid, and for women with an increased risk, this dose can be increased up to 5 mg..

The high-risk group includes:.

• Women who have had babies with neural tube defects.

• Taking folic acid antagonist drugs.

• Weakened by malnutrition.

• Patients with diabetes.

• Smoking women.

Vitamin A is a special issue, as excess retinol (10,000 UI per day or more) can lead to fetal malformations. In this context, the most preferred form of vitamin A is not retinol, but beta-carotene (Wilson R. Johnson J. , 2008).

Immunization.

In the United States and Canada, doctors believe that before planning a pregnancy, a woman should be immunized against the following diseases:.

• Chicken pox.

• Flu.

• Diphtheria.

• whooping cough.

• Measles.

• Rubella.

• Tetanus.

• Parotitis.

All of these infections are potentially harmful to the fetus.. Chickenpox and rubella during pregnancy can cause serious malformations.

It is recommended to abstain from conception for at least 4 weeks after routine vaccination with a live vaccine, given the theoretical risk that the virus may infect the fetus (Berghella V. , 2010).

Influenza vaccination reduces the risk of maternal complications and provides passive protection to the newborn baby (Fiore A. , Uyeki T. , 2010). The same can be said about some other vaccines..

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