Main Article Content

Gal Neuman


Preconception counselling, risk assessment, maternal education, folic acid supplementation, diabetes mellitus, obesity, dyslipidemia, seizure disorder, drug exposure


As the reproductive age of women increases, women of reproductive age are exposed to more diseases and medications that are potentially related to adverse pregnancy outcomes. The approach to primary prevention of such outcomes is discussed. By minimizing the risks related to the diseases and the medications before conception, the best control of the medical condition and optimized pharmacotherapy is achieved when conception eventually occurs.

Abstract 141 | PDF Downloads 56


1. Eichholzer M, Tönz O, Zimmermann ER. Folic acid: a public -health challenge. Lancet 2006;367(9519):1352- 1361.
2. Folic acid: for preconception and pregnancy [Internet]. Ottawa (ON): The Society of Obstetricians and Gynaecologists of Canada; 2007 [cited 2014 Sep 19]. Available from: -acid -for - preconception -and -pregnancy
3. Bar-Oz B, Koren G, Nguyen P, et al. Folate fortification and supplementation - are we there yet? Reprod Toxicol 2008;25(4):408- 412.
4. Reece EA. Matern al fuels, diabetic embryopathy: pathomechanisms and prevention. Semin Reprod Endocrinol 1999;17(2):183- 194.
5. Mathiesen ER, Ringholm L, Damm P. Stillbirth in diabetic pregnancies. Best Pract Res Clin Obstet Gynaecol 2011;25(1):105- 111.
6. Becerra JE, Khoury MJ, Cordero JF, et al. Diabetes mellitus during pregnancy and the risks for specific birth defects: a population-based case-control study. Pediatrics 1990;85(1):1- 9.
7. Ray JG, O'Brien TE, Chan WS. Preconception care and the risk of congenital anomalies in the offspring of women with diabetes mellitus: a meta-analysis. QJM 2001 [cited 2014 Jul 27];94(8):435- 444. Available from: ?view=long&pmid=11493721
8. Napoli C, Palinski W. Maternal hypercholesterolemia during pregnancy influences the later development of atherosclerosis: clinical and pathogenic implications [editorial]. Eur Heart J 2001 [cited 2014 Jul 27];22(1):1- 9. Available from: up?view=long&pmid=11133201
9. Drugs and Supplements. Red yeast rice (Monascus purpureus) [Internet]. Rochester (MN): Mayo Foundation for Medical Education and Research; c1998 -2014 [last updated 2013 Nov 1;cited 2014 Jul 27]; [about 8 screens]. Available from: - supplements/red -yeast -rice/background/hrb - 20059910
10. Daniels SR, Greer FR; Committee on Nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics 2008 [cited 2014 Sep 19];122(1):198- 208. Available from: kup?view=long&pmid=18596007
11. Taguchi N, Rubin ET, Hosokawa A, et al. Prenatal exposure to HMG -CoA reductase inhibitors: effects on fetal and neonatal outcomes. Reprod Toxicol 2008;26(2):175- 177.
12. Ofori B, Rey E, Bérard A. Risk of congenital anomalies in pregnant users of statin drugs. Br J Clin Pharmacol 2007 [cited 2014 Jul 27];64(4):496- 509. Available from: 17506782
13. Pollack PS, Shields KE, Burnett DM, et al. Pregnancy outcomes after maternal exposure to simvastatin and lovastatin. Birth Defects Res A Clin Mol Teratol 2005;73(11):888- 896.
14. Kusters DM, Hassani Lahsinoui H, van de Post JA, et al. Statin use during pregnancy: a systematic review and meta-analysis. Expert Rev Cardiovasc Ther 2012;10(3):363- 378.
15. Zarek J, DeGorter MK, Lubetsky A, et al. The transfer of pravastatin in the dually perfused human placenta. Placenta 2013;34(8):719- 721.
16. Familial hypercholesterolaemia. NICE quality standard 41. Manchester (UK): National Institute for Health and Care Excellence; September 2013 [cited 2014 Sep 19]. Available from:
17. Tellez -Zenteno JF, Pondal -Sordo M, Matijevic S, et al. National and regional prevalence of self - reported epilepsy in Canada. Epilepsia 2004 [cited 2014 Sep 19];45(12):1623- 1629. Available from: 3-9580.2004.24904.x/pdf
18. Theodore WH, Spencer SS, Wiebe S, et al. Epilepsy in North America: a report prepared under the auspices of the global campaign against epilepsy, the International Bureau for Epilepsy, the International League Against Epilepsy, and the World Health Organization. Epilepsia 2006 [cited 2014 Sep 19];47(10):1700- 1722. Available from: 8-1167.2006.00633.x/pdf
19. Battino D, Tomson T. Management of epilepsy during pregnancy. Drugs 2007;67(18):2727- 2746.
20. Walker SP, Permezel M, Berkovic SF. The management of epilepsy in pregnancy. BJOG 2009;116(6):758- 767.
21. Chandranipapongse W, Koren G. Preconception counseling for preventable risks. Can Fam Physician 2013 [cited 2014 Jul 27];59(7):737- 739. Available from: pmid=23851536
22. Walfisch A, Koren G. Preconception counseling: rational, practice and challenges. Minerva Ginecol 2011;63(5):411- 419.