[Click! Health] "If Preparing for Pregnancy, Get a 'Pre-Pregnancy Checkup'"

As interest in pre-pregnancy screening for planned pregnancies grows, medical experts emphasize the importance of such screenings.

According to Korea University Guro Hospital, with increasing health awareness and rising marriage and childbirth ages, interest in pre-pregnancy screening is also increasing. Medical professionals advise that if you are planning to conceive, it is beneficial to undergo pre-pregnancy screening. This is because the screening can help prevent exposure to risk factors. We have summarized the importance of pre-pregnancy screening in a Q&A format with Professor Jo Geum-jun from the Department of Obstetrics and Gynecology at Korea University Guro Hospital.

Why is pre-pregnancy screening important?

Pre-pregnancy screening is the first step toward a planned pregnancy. By undergoing screening before conception, exposure to medications or harmful environments during the early stages of pregnancy?when the embryo develops and grows?can be prevented in advance.

First, the screening can identify and correct previously unknown underlying diseases or assess the course of known chronic conditions, allowing for adjustments to medications or treatment plans suitable for pregnancy. Additionally, it checks for antibody formation against infectious diseases that could affect the fetus; if antibodies are absent, vaccinations can be administered before preparing for pregnancy. Nutritional status can also be assessed to supplement any deficiencies in nutrients necessary for pregnancy.

Do pre-pregnancy screening items differ by age?

The screening items are generally the same regardless of age, but there are specific considerations for adolescent and advanced-age pregnancies. In adolescent pregnancies (ages 15 to 19), risks such as anemia, preterm birth, and eclampsia increase, and since growth and development continue during pregnancy, higher calorie intake is necessary. Additionally, the incidence of sexually transmitted diseases is higher, and exposure to substance abuse may persist, requiring careful management.

In advanced-age pregnancies (35 years and older), the frequency of gestational diabetes, gestational hypertension, preterm birth, low birth weight infants, placenta previa, placental abruption, and cesarean deliveries increases. There is also a higher risk of idiopathic preterm labor, fetal aneuploidy, multiple pregnancies due to assisted reproductive technologies, and fetal malformations, necessitating continuous monitoring.

What should be done if planning a pregnancy?

According to domestic research, about 50% of pregnancies are estimated to be unplanned. Unplanned pregnancies are known to increase exposure to risk factors such as smoking, alcohol consumption, and drugs by approximately 1.5 times.

For a safe and healthy childbirth, it is most desirable to plan the pregnancy. Planning allows for prevention of exposure to risk factors from before conception and enables confirmation of underlying diseases to establish treatment plans. Furthermore, if there is no immunity to hepatitis B virus or rubella antibodies, vaccinations can be completed before welcoming the baby. It is recommended to start taking folic acid at least three months before planning to conceive.

Is it advisable to have an ovarian reserve test (AMH) before preparing for pregnancy?

Generally, in groups requiring artificial insemination, a low ovarian reserve test (AMH) value may predict a poor response to artificial insemination. However, it is known to have no predictive value regarding whether pregnancy will occur. Not all women preparing for pregnancy need to undergo AMH testing; it is useful for women preparing for artificial insemination who are suspected of diminished ovarian function (such as advanced age or a history of ovarian surgery).

What is the criterion for infertility treatment?

Infertility is defined as the failure to conceive after one year of regular, unprotected intercourse. Approximately 85-90% of healthy young couples conceive within one year. For women aged 30 or older who have irregular menstruation, severe dysmenorrhea, or severe dyspareunia, or for women aged 35 or older who have not conceived after six months of trying, it is advisable to investigate the causes of infertility.

What should be done if taking medication for an underlying disease?

There are chronic diseases diagnosed before pregnancy that require continuous medication during pregnancy. Examples include immune diseases such as lupus or rheumatoid arthritis; neuropsychiatric disorders such as epilepsy, panic disorder, and depression; cardiovascular diseases; respiratory diseases; and endocrine disorders such as diabetes or thyroid dysfunction.

Women with chronic diseases often hesitate to attempt pregnancy or may stop medications arbitrarily once pregnancy is confirmed due to concerns about the effects of the disease or medications on the fetus. However, if the underlying disease is not controlled during pregnancy, it can harm both the fetus and the mother’s health. Therefore, close consultation with both the primary physician managing the underlying disease and the obstetrician is crucial. Most medications can be managed without increasing the risk of fetal malformations beyond baseline risk or can be substituted with safer alternatives, allowing pregnancy to be maintained while managing the underlying condition.

Professor Jogeum Jun, Department of Obstetrics and Gynecology, Korea University Guro Hospital. [Photo provided by Korea University Guro Hospital]

This content was produced with the assistance of AI translation services.