As accessible health care providers, pharmacists have a unique opportunity to improve preconception health in women which can lead to overall improved pregnancy outcomes. If women are thinking about conceiving a baby, it is important that they are counseled on prenatal supplementation and vaccinations. The information that a pharmacist can provide can help the woman make informed decisions about their lifestyle.
Screening for immunizations for measles, mumps, rubella, varicella, human papillomavirus, hepatitis A, and hepatitis B should all be recommended for women thinking about conceiving since they may have harmful effects on the developing fetus after conception. Not all vaccinations are off limits however. Inactivated influenza virus and tetanus, diphtheria, and pertussis vaccinations are recommended) even if the woman is pregnant (regardless of trimester) and should not pose a risk to the fetus. Moreover, contraction of influenza may cause problems for the baby. Influenza contraction in the first trimester gives rise to higher incidence of schizophrenia in the child. Contraction of the virus in the second and third trimesters poses more risk for the mother as breathing is impaired and the fetus is applying pressure on the mother’s diaphragm and lungs.
Counseling the woman on supplementation of folic acid may also lead to improved pregnancy outcomes as this B vitamin has been shown to improve optimal birth outcomes and neural tube development. Deficiency of this vitamin may result in spina bifida, a condition in which the spine does not close properly which can result in paralysis or mental retardation. It can also result in anencephaly or the case in which the brain does not form altogether. Since these events occur in the developing fetus within the first 28 days, it is important that the woman supplements this ahead of time.
Pharmacists have a role in helping educate people about medication day to day. However this role may be all the more important when discussing good preconception habits with women. This is a situation that there is a good chance that they have not been in before and since the development of the fetus is so fragile, it is important to make sure that they are getting all of the information correct in order to improve the likelihood of optimal birth outcomes.
El-Ibiary S, Raney E, Moos M. The pharmacist’s role in preconception health. J Am Pharm Assoc. 2014; 54(5): 288-303