Rethinking prenatal care

When most people think about prenatal care, we consider the obvious; stop drinking, quit smoking, eat better and take folic acid.  We've known for a very long time that folic acid helps prevent neural tube defects early on during the pregnancy.  Outside of that, medical opinion has recently evolved to include the significance of maternal intake of omega 3 fats for healthy brain development.  Most professionals recommend a general prenatal multivitamin as well.  We're going to head into a series that covers a few topics beyond the usual recommendations.

Mom's health is very important for the baby.  I know that we all know that.  But let's dig a little deeper so we start to understand the real significance of Mom's health and how far-reaching the consequences of poor health are.  Most Mom's and their doctors have as their goal; full-term pregnancy with safe delivery.  No complications during pregnancy (gestational diabetes, preeclampsia etc.) and a healthy baby with a good APGAR score.

Those are great outcome measures.  There's nothing wrong with these goals.  Quite the opposite- these goals should be a major priority and a measuring stick of success.  But is it beyond reason to hope for more? Can we actually have a goal of optimizing the neuroendocrine immune system to reduce the risk of chronic disease later in life?  The answer is yes.  But the only way to do this is by appreciating the integration of body systems.

Let's start with one paper.

"...prenatal stress (i.e. stress experienced by the pregnant mother with impact on the fetal ontogeny) has programming effects on the hypothalamic-pituitary-adrenocortical axis, brain neurotransmitter systems and cognitive abilities of the offspring"

To appreciate the significance, we need to understand the role of the hypothalamic-pituitary adrenal axis and the result of a compromise in that system.  To state it simply; Mom's stress can interfere with the child's brain development, hormone activity, neurotransmitter levels and ability to think.   These are not traditional "birth defects".  But it happens.

How many American woman have high levels of uncontrolled stress?  Do they have babies? Even with all 10 fingers and all 10 toes, have those babies been "dealt a bad hand"?  We'll continue to explore this topic.