Ideally, all women should prepare for a future pregnancy by optimising their health. It is recommended that all women seek pre-conception counselling from their general practitioner.
Factors in a woman’s history that increase her risk of subsequent preterm birth include:
Counselling should include:
- a personal or family history of early birth
- prior surgical intervention on the woman’s cervix and
- recurrent miscarriages.
- Risk stratification based on history is important for future pregnancy management.
- strategies to normalise body weight
- avoidance of smoking and exposure to second-hand cigarette smoke
- avoidance of recreational substance abuse
- education regarding alcohol consumption and
- assurance that supplementary folate is taken daily for at least three months before conception.
Women with medical conditions that affect pregnancy outcomes require diagnostic and therapeutic management in order that they enter pregnancy with the best possible health.
Management should include:
- rigorous control of blood glucose levels in women with diabetes
- control of blood pressure in women with hypertension
- stabilisation of autoimmune conditions and
- referral to appropriate specialists when required.
Medications should be reviewed and altered if required to be suitable for use in pregnancy.
Where appropriate, women may benefit from being informed that preterm birth is more common at the extremes of maternal age and after inter-pregnancy intervals less than 18 months.