• To improve health of mother and partner before trying for a baby, in order to optimise chances of conceiving

Points to discuss

• Age - Conception over 35, increased chance of miscarriage and chromosomal issues
• Chances - About 84% of couples will conceive naturally within a year if they have regular unprotected sex

Nutrition:

• Take folic acid 400mcg from before pregnancy to 12 weeks (reduces neural tube defects), women at higher risk of conceiving a child with NTD should take 5mg:
  • MORE: Metabolic disease (diabetes and coeliac disease), Obesity (BMI >30), Relative or personal history of neural tube defect, Epilepsy
• Iron supplementation should be offered routinely
• Take vitamin D supplement (10 mcg or 400 IU daily)
• Avoid vitamin A supplements and eating liver or pate (vitamin A is teratogenic at high doses)
• Don’t drink alcohol when pregnant (risk of fetal alcohol syndrome)
• Don’t smoke (smoking has a long list of complications)
• Avoid unpasteurised dairy or blue cheese (risk of listeriosis)
• Avoid undercooked or raw poultry (risk of salmonella)
• Continue moderate exercise but avoid contact sports

Smoking in pregnancy

Smoking in pregnancy increases the risk of:

• Fetal growth restriction (FGR)
• Miscarriage