"The child-bearing years are an exciting time in a woman's life and there are a number of steps they can take to be healthy, benefiting both them and their future child," said Dr. Julie Gerberding, CDC director. "For instance, even before pregnancy, women of child-bearing age should see their doctor about controlling existing medical conditions, such as diabetes, high blood pressure and eating disorders. They should take 400 micrograms of folic acid to help prevent neural tube defects and avoid smoking or drinking alcohol."

The recommendations on preconception health and health care identify more than a dozen risk factors and conditions that require interventions before pregnancy to be effective. Among developed nations, the United States is ranked 26th in infant mortality. If implemented, the recommendations can help improve the health of babies and moms.

"Preconception health is important for every woman capable of having a baby, and should be tailored to each individual," said Dr. José Cordero, director of CDC's National Center on Birth Defects and Developmental Disabilities and Assistant Surgeon General. "And all couples, whether or not they are planning pregnancies, should have a reproductive life plan, which is a set of personal goals about having (or not having) children. This also includes couples who have a difficult time getting pregnant; they should discuss their options with their health care professional."

Some topics:

• Folic acid supplements to prevent neural tube defects
• Detecting and treating existing health conditions
• Reviewing medications that can affect the fetus or the mother
• Reviewing a woman's pregnancy history
• Stopping smoking to reduce the risk of low birth weight
• Eliminating alcohol consumption to prevent fetal alcohol syndrome
• Family planning counseling to avoid unplanned pregnancies
• Counseling to promote healthy behaviors such as appropriate weight, nutrition, exercise and oral health.

These recommendations will also give physicians and other health care professionals the knowledge, messages and tools to act on the scientific evidence that exists concerning about how and when to intervene for preconception care.

"I encourage all women who are thinking about getting pregnant to talk to their doctor about medications, including those bought without a prescription. They should also avoid exposure at work or at home to toxic substances or potentially infectious materials, such as chemicals or cat feces," added Dr. Cordero.

The recommendations are the result of two-years of collaborative efforts with a number of partner groups including American College of Obstetricians and Gynecologists, National March of Dimes Birth Defects Foundation, CityMatCH (Urban Maternal and Child Health Leadership), Association of Maternal and Child Health Programs, American College of Nurse Midwives, American Academy of Pediatrics, National Association of County and City Health Officials, Association of State and Territorial Health Officials, and American Academy of Family Physicians. 

The full recommendations on preconception care are available at www.cdc.gov/mmwr and for more information on preconception care go to www.cdc.gov/ncbddd