Despite major advances in medical care, poor
birth outcomes continue to be a problem in the United States. Each
year, 12% of babies are born premature, 8% are born with low birth
weight, and 3% have major birth defects. Of women giving birth, 31%
suffer pregnancy complications. Risks associated with poor
pregnancy outcomes remain prevalent among women of reproductive
age. For example, 11% of women smoke during pregnancy, and 10%
consume alcohol. Of women who could get pregnant, 69% do not take
folic acid supplements, 31% are obese, and about 3% take
prescription or over the counter drugs that are known teratogens.
In addition, about 4% of women have preexisting medical conditions,
such as diabetes, that can negatively affect pregnancy if
unmanaged. All of these factors pose risk to pregnancies, but could
be addressed with proper health interventions.
Prenatal care, which usually begins at week 11
or 12 of a pregnancy, comes too late to prevent a number of serious
maternal and child health problems in the U.S. The fetus is most
susceptible to developing certain problems in the first 4-10 weeks
after conception, before prenatal care is normally initiated.
Because many women are not aware that they are pregnant until after
this critical period of time, they are unable to reduce the risks to
their own and to their baby’s health unless intervention begins
before conception.
Preconception care is critical to improving the
health of the nation. The Healthy People 2000 goals set a target
aiming for 60% of primary care physicians to provide age-appropriate
preconception care, yet only about one in four providers currently
provides preconception care to the majority of the women they
serve. Preconception care could succeed in improving maternal and
child health where the current paradigm is failing, but most
providers don’t provide it, most insurers don’t pay for it, and most
consumers don’t ask for it.
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Date: April 12, 2006
Content source: National Center on Birth Defects and Developmental
Disabilities
