Preconception Care: A New Standard of Care within Maternal Health Services

Abstract

Emerging research suggests that much pediatric affliction has origins in the vulnerable phase of fetal development. Prenatal factors including deficiency of various nutrients and exposure to assorted toxicants are major etiological determinants of myriad obstetrical complications, pediatric chronic diseases, and perhaps some genetic mutations. With recent recognition that modifiable environmental determinants, rather than genetic predestination, are the etiological source of most chronic illness, modification of environmental factors prior to conception offers the possibility of precluding various mental and physical health conditions. Environmental and lifestyle modification through informed patient choice is possible but evidence confirms that, with little to no training in clinical nutrition, toxicology, or environmental exposures, most clinicians are ill-equipped to counsel patients about this important area. With the totality of available scientific evidence that now exists on the potential to modify disease-causing gestational determinants, failure to take necessary precautionary action may render members of the medical community collectively and individually culpable for preventable illness in children. We advocate for environmental health education of maternity health professionals and the widespread adoption and implementation of preconception care. This will necessitate the translation of emerging knowledge from recent research literature, to health professionals, to reproductive-aged women, and to society at large.

Heavy metal contamination of prenatal vitamins

“…The gestational period on the continuum of human life is a phase of particular vulnerability to toxic exposures, including adverse chemical agents [ 1 ]. With the high toxicant-to-mass ratio of the fetus at a critical time of growth and development, adverse exposure during pregnancy presents a particular risk.…”

“…With the high toxicant-to-mass ratio of the fetus at a critical time of growth and development, adverse exposure during pregnancy presents a particular risk. Unfolding evidence in the medical literature confirms that toxicant exposures to reproductive-aged women and consequently to their developing progeny by vertical transmission are responsible for myriad developmental and long-term health problems [ [1] , [2] , [3] , [4] , [5] , [6] ].…”

“…Along with the recognition of potential fetal origins of chronic pediatric and adult disease [ [1] , [2] , [3] , [4] , [5] , [6] ], a constellation of three primary factors has contributed to the escalating concern regarding vertical transmission of toxic agents: Epidemiological studies by major groups such as the Centers for Disease Control confirm that toxic chemical agents are now polluting the bodies to some degree of most men, women, children and newborns in North America [ 7 , 8 ]; Recent research suggests that because of an immature detoxification capability, developing children in-utero may accrue and thus experience higher levels of toxicant exposure than their mothers [ 9 ]. Most health professionals providing specialized maternity care do not explore myriad sources of gestational contamination as they lack training in environmental and toxicological determinants of fetal compromise [ 10 ].…”

Developmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk

“…If women are provided with information regarding healthy habits prior to pregnancy, their ability to plan ahead and prepare for a healthier pregnancy may be greatly increased [87]. Recent findings from human epidemiological studies have provided evidence that preconception exposures may influence perinatal outcomes.…”

Human Elimination of Organochlorine Pesticides: Blood, Urine, and Sweat Study

“…An issue of particular concern is fetal and early life exposure to xenobiotics at critical times of development as a result of maternal exposure and bioaccumulation [ 48 ]. Although OCPs were not specifically measured, a recent cord-blood study revealed an accumulation of various toxicants in neonates at birth [ 49 ].…”