PRECONCEPTUAL CARE AND PREGNANCY OUTCOME

Foresight 1990-1993 Study of Preconceptual Care and Pregnancy Outcome
[Copy of a letter to the Editor, Journal of Nutritional & Environmental Medicine (1995) 5, 205-208]

Letters to the Editor

PRECONCEPTUAL CARE AND PREGNANCY OUTCOME

Sirs: We would like to report the pregnancy outcomes achieved by 367 couples, average ages 34 (22-45) for females and 36 (25 - 59) for males, who had been enrolled on a Foresight (The Association for the Promotion of Preconceptual Care) [1] preconception programme during 1990-92. Foresight clinicians completed investigations of both partners which included health questionnaires, analysis of essential nutrient status in blood, hair and / or sweat, and semen analysis. Common, but often symptomless, genito-urinary infections were sought by testing endocervical swabs, urine and post-prostatic massage secretions while blood was tested for chlamydial antibodies to diagnose active pelvic inflammatory disease [2, 3] .

Data evaluation showed that 90% of males and 60% of females regularly drank alcohol while 45% of the men but 57% of the women smoked. Among the 367 couples, 217 (59%) had a previous history of reproductive problems; 136 (37%) had suffered from infertility (for <1 to >10 years) and 139 (38%) had histories of from one to five previous miscarriages; 11 (3%) had given birth to a stillborn child, 40 were small-for-dates and 15 were of low birthweight (<2500g); 7 were malformed and 3 infants died of sudden infant death syndrome. A total of 86 females reported more than one of these problems. Of the male partners, 154 (42%) had a semen analysis because of infertility and most had a reduction in sperm quality. Commonest complaints among prospective parents were fatigue, headaches/migraine, cold feet, back pain, abdominal bloating and constipation.

Written and telephone follow-ups carried out in 1993 revealed that 327 (89%) of the women had become pregnant and 327 children had been born since enrolment. There were no multiple pregnancies. In remarkable contrast to the couples' previous experience, all their babies (137 males and 90 females ) were born healthy and were well developed at birth which occurred form 36 to 41 weeks (mean 38.5 weeks). Average birth weight was 3265g (2368 - 4145). None were malformed and none were transferred to special baby care units. Among 204 couples with infertility problems, 175 (86%) had achieved healthy pregnancies.

NEIL WARD PhD
Director of Research, Department of Chemistry, University of Surrey, Guildford, GU2 5XH, UK.

With acknowledgements to the following doctors who participated in the study:

Dr Marilyn Glenville Bed MA PhD Dip EHP NLP
Dr Ellen Grant MB ChB DObst RCOG
Dr Jonathan Hardy MA BM MF HOM
Dr Tom Heyes MA MB BC HIR DRCOG MRCGP
Dr Patrick Kingsley MB BS MRCS LRCP DObst RCOG
Dr J. Meldrum MB ChB DCH DA DObst RCOG MRCGP HTD
Dr Jenny Nevison MN BS
Dr M. Nightingale MB BS MRCGP FFARCS MRCS LRCP
Dr Patricia Sankey MB ChB MRCGP DObst RCOG
DR C. Scott-Moncrieff MB ChB MFH OM
Dr Pamela Tatham MB BS (London)
Dr K. Thorley MA MB CHhir MRC GP DRCOG
.

REFERENCES:-

[1] Barnes B, Grant E, Mumby K et al. Nutrition and pre-conception care. Lancet 1985; i: 1297.

[2] Barnes B, Bradley SG. Planning for a Healthy Baby. London: Ebury Press, 1990.

[3] Grant ECG. Sexual Chemistry. London: Cedar, Reed Books, 1994.

NOTE:-
This is one of a series of documents published by FORESIGHT, the Association for the Promotion of Pre-conceptual Care. The purpose of these documents is to make the great wealth of information that can be found in medical and other scientific journals available to prospective parents, health professionals or anyone else who does not have the time and/or the facilities to read them for themselves.

More:- Foresight Literature Summaries

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