Preconception Care: A New Standard of Care within Maternal Health Services.
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.
Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada T5H 3V9; University of Calgary, Calgary, AB, Canada.
Stephen J
SJ
Genuis
Millcreek Environmental Health Clinic, Edmonton, AB, Canada T6K 4C1.
Rebecca A
RA
Genuis
D002170:Canada; D005260:Female; D006176:Gynecology / Q000592:standards*; D006801:Humans; D000068097:Maternal Health / Q000592:standards*; D008427:Maternal Health Services / Q000592:standards; D009774:Obstetrics / Q000592:standards*; D010353:Patient Education as Topic / Q000592:standards; D017410:Practice Guidelines as Topic; D016742:Preconception Care / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*