Preconception Care

Updated: Mar 29

Creating Healthy Babies

With the enormous rise in childhood chronic disease such as allergies, eczema, asthma, autism, diabetes and attention deficit disorder, there are steps that future parents can take to help reduce the risk of their child being affected. All of these conditions are complex, and I am not claiming to know a fail-proof way to eliminate risk entirely, but there are steps you can take preconception that make a clear impact. Here are some starting points:

Nutrition:

Nutrition is key, especially minimizing any deficiencies of key nutrients. This means eating sufficient dietary protein, a diet rich in colourful fruits and vegetables, lots of dark leafy greens as a source of natural folate, DHA and omega-3 fats, and minimizing sugar and foods made with white flour.

Another factor with nutrition is to address food intolerances and sensitivities, as they cause inflammation and immune system stress. This may affect the ability to conceive, can definitely aggravate any inflammatory conditions (for example, endometriosis, inflammatory bowel disease, joint pains), and inflammation in pregnancy can affect the health of your future baby.

Supplements:

There is plenty of evidence stating the importance of starting prenatal vitamins 3 months preconception, and most of us are aware of the need to take folate supplements in order to prevent neural tube defects. One study in particular (1) showed that in genetically susceptible mothers who took prenatal vitamins 3 months preconception and in the 1st month of pregnancy, had a 720% decreased relative risk of autism in their child. These stats are quite remarkable, given the fact that the genetic susceptibilities discussed are carried by 10-25% of the population. They included MTHFR, CBS and COMT – more about these will be discussed below.

A high quality prenatal vitamin is recommended preconception, and one that contains adequate support for methylation, meaning the correct forms of folate, vitamin B12 and vitamin B6 especially. Additional supplements may include: vitamin D, omega-3 supplements, and possibly extra zinc and iron if needed. If a woman is over the age of 35, then extra antioxidants to support egg quality would also be recommended, especially Coenzyme Q10.

Genetic testing:

Given the volume of recent research on genetic polymorphisms, especially one called MTHFR (Methylenetetrahydrofolate reductase), which is an enzyme that converts folate into the readily usable form called methylfolate. When someone carries a defect in the MTHFR gene, there is a reduction in methylation by up to 90%. Some general health effects of MTHFR defects include: heart disease, stroke, high blood pressure, anxiety, depression, migraines, cancer, addictions, and high homocysteine levels. If your family history contains many of these issues, especially heart disease presenting at a young age (under 60), testing for MTHFR is highly recommended.

The MTHFR polymorphism can affect the following related to pregnancy and conception:

  1. Neural tube defects (spina bifida, anencephaly)

  2. Cleft lip and cleft palate

  3. Congenital heart disease

  4. Pregnancy induced hypertension

  5. Miscarriages related to blood clots

  6. Infertility

  7. Autism (2)

Gastrointestinal health:

An additional factor to address preconception is maternal gastronintestinal health, especially the balance of organisms in the gut. Dysbiosis or imbalance of digestive flora has been associated with type II diabetes, obesity, inflammatory bowel disorders, mood disorders, among others. Given that the newborn baby’s gastrointestinal tract is first ‘seeded’ with bacteria through vaginal birth, maternal balance of flora is very important to a newborn’s health. Having an improper balance of organisms can also affect the progression of pregnancy: dysbiosis and too much of the ‘wrong’ bacteria has been linked to premature rupture of membranes and premature birth (4).

Supporting digestive health can also reduce the risk of allergic disease in children. For example, taking probiotic supplements in pregnancy reduces the risk of allergies by 12% (3).

Other factors to address:

There are many other factors to address in a preconception plan, with the aim being to have both parents in optimal health first. Here is a short list of considerations:

  1. Alcohol intake (maternal and paternal intake preconception are relevant).

  2. Infections – certain infections can affect fertility and pregnancy outcome (chlamydia, trichamoniasis, and others).

  3. Stress levels.

  4. Autoimmune conditions.

  5. Being optimal body weight.

  6. Blood sugar metabolism / insulin resistance and pre-diabetes (All can increase your risk of gestational diabetes, and can also affect future child’s susceptibility to blood sugar disorders later in life).

  7. Medication use – maternal and paternal.

  8. Toxin exposure.

This is an exciting topic, as we learn to take more proactive approach to preconception. It is amazing how small changes before conception, and spending time focusing on parental health can have such a great impact to reduce health risks in our children.

References:

  1. Schmidt, Rebecca, Hansen, Robin, Hartiala, Jaana, et al., Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk of Autism, Epidemiology, Vol 22, No. 4, July 2011; 476-485

  2. James SJ, Melnyk S, Jerginan S, et al. A functional polymorphism in the reduced folate carrier gene and DNA hypomethylation in mothers of children with autism. Am J Med Genet B Neuropsychiatr Genet. 2010;153B: 1209-1220

  3. Elazab N, Mendy A, Gasana J, et al. Probiotic Administration in Early Life, Atopy, and Asthma: A Meta-analysis of Clinical Trials. Pediatrics. August 2013.

  4. Fortner KB, Grotegut CA, Ransom CE, et al. Bacteria Localization and Chorion Thinning among Preterm Premature Rupture of Membranes. PLOS One. January, 2014


Dr. Shawna Darou is a licensed and registered Naturopathic Doctor, who graduated from the Canadian College of Naturopathic Medicine (www.ccnm.edu) at the top of her class and was the recipient of the prestigious Governor’s Medal of Excellence. She is a member of the Ontario Association of Naturopathic Doctors, the Canadian Naturopathic Association and the Institute of Naturopathic Education and Research. Naturopathic medicine is her second career, her first being Engineering Chemistry from Queen’s University. She now uses her analytical brain and problem solving skills especially in the complicated arena of hormonal health, and in solving health puzzles.

Dr. Shawna Darou ND has a clinical focus in women’s health care and fertility, and has treated thousands of women in her Toronto clinic since 2004. She is a dedicated and caring doctor with a gentle approach who is committed to the health of her patients. Dr. Darou’s is also an avid health writer, and her popular health blog is read by close to 5,000 people each week!

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