Finding out you are pregnant is probably one of the many joys in life. It is an exciting time. Whether it’s your first or your fourth child, you hope for a healthy and happy baby.
As parents, we have an inherent expectation that everything will be just fine. But a pregnancy can change from normal to complex unexpectedly, which can lead to premature births or newborn congenital anomalies.
According to national sources:
▪ The preterm birth rate in the U.S. has worsened for the first time in eight years. In many Valley counties, it exceeds 9 percent. The March of Dimes goal is 8.1 percent by 2020.
▪ Preterm birth is the most common cause of infant death and the leading cause of long-term disability related to the nervous system in children, according to the National Institute of Child Health and Human Development.
▪ Birth defects affect 1 in 33 babies (about 3 percent of all babies) born in the U.S. each year, reports the Centers for Disease Control.
No one knows for sure what causes preterm births. But studies show many factors can lead to pregnancy complications, including demographics, stress levels, lifestyle behaviors and unhealthy habits.
So what should you do before and during a pregnancy?
Among many things, a healthy diet and lifestyle are essential. Folic acid is known to help prevent birth defects, so you can take it daily as you plan to become pregnant and early on in the pregnancy.
Tell your doctor about medical issues such as diabetes, seizure disorders or if you are taking medications. Certain medications might have to be stopped a few months before pregnancy to avoid complications.
Exercise appropriately. Don’t drink. Don’t smoke. Don’t use drugs. Avoid toxic substances. And just as important, see your doctor for all prenatal check-ups. Regular prenatal care helps to identify health issues early and to promote healthy behaviors.
As part of your physical examinations, your doctor will order ultrasound, blood and urine tests to check:
▪ Your environment and health habits,
▪ Your overall health (blood pressure, weight, etc.),
▪ Your baby’s growth, oxygen levels, and heart rate,
▪ Signs of infection.
Depending on risk factors such as age, weight, family history, pregnancy with multiples or results from your routine test, your doctor might suggest additional prenatal screenings to get more detail about the health and condition of your baby.
Make sure to follow through on your doctor’s recommendations. Screenings evaluate individualized risk and are universal for all pregnant moms, regardless of age. They are useful to detect potential chromosomal and congenital abnormalities such as Down syndrome, cleft lip/cleft palate, gastroschisis, spina bifida or heart disorders. Screenings are also helpful if you, or your partner, are known carriers of a genetic disorder like cystic fibrosis.
The California Prenatal Screening program, focused on detecting birth defects during pregnancy, is working to assure prenatal screening services and follow-up diagnostic services are available to all pregnant women in California. For most moms-to-be, reassurance means everything. Having more information through these tests can provide peace of mind or help prepare for any special attention the baby might need immediately after delivery.
Screenings are non-invasive procedures through high resolution 2D or 3D ultrasound and maternal blood tests. In the first trimester, a nuchal translucency ultrasound examines the back of the baby’s neck for increased fluid or thickening. A mid trimester ultrasound examines the baby’s anatomy for birth defects. Blood tests taken in the first and mid trimester measure specific substances in the blood that also indicate chromosomal abnormalities. In the case of Down syndrome, results can indicate 85-90 percent likelihood.
Based on screening results, your doctor might also suggest diagnostic genetic testing to confirm or rule out health issues. Genetic tests include amniocentesis or chorionic villus sampling. These procedures are more invasive where small samples of amniotic fluid or cells from the placenta are taken. The samples are examined to check the baby’s chromosomes and test for genetic diseases.
Valley Children’s Maternal Fetal Center is a designated diagnostic center for the California PNS Program, providing comprehensive screening and diagnostic tests as well as genetic counseling. We can identify 80-90 percent of babies who will need early neonatal intervention. Because a majority of birth defects can be treated immediately after birth, our newborn care subspecialists are also highly skilled to treat many congenital anomalies.
Sometimes preparation for a baby is just adjusting your lifestyle or establishing healthier habits. Sometimes it is learning more about an unanticipated diagnosis.
Staying informed about your baby’s condition can help manage your expectations and allow you and your doctor to make the best decisions possible – whether your baby arrives early or right on time.
One of the most important events nationwide in combating birth defects is the March of Dimes, which is Saturday at 9 a.m. starting at the Gallo Center. So far, there have been pledges of $63,800 for the march. Go to www.marchforbabies.org to pledge or learn more.
Dr. David McLean is the Medical Director of the Maternal Fetal Center at Valley Children’s Healthcare. He wrote this for The Modesto Bee.