Health of parents key to fetal development

By Elvina Karyadi

JAKARTA (JP): All parents wants their children to be fit and healthy. Many focus on eating well, obtaining sufficient calories and nutrition, for their reproductive health. Yet many other factors, involving both the father and mother, must be taken into account in determining the outcome of the pregnancy.

Sperm from a man's body unites with a woman's egg to create a totally unique and genetically irreplaceable human life. Many women are unaware of their pregnancy in the crucial development of the fertilized egg into a fetus during the first eight weeks.

A woman's nutritional health and presence of toxins will determine whether the baby will develop normally.

These same factors will influence the quality of the father's sperm.

Researchers believe a biological father's occupational or lifestyle hazards, including smoking, drinking alcohol, taking non-prescribed drugs and exposure to toxic chemicals, may affect sperm content.

Poor nutritional status of the mother, such as protein and essential fatty acid deficiency, inadequate carbohydrate intake, vitamin and mineral deficiency, low body weight and slimming programs, can increase the risk of congenital malformation.

Other influences on fetal health include drugs, such as birth control pills, anticonvulsants, and prohibited substances such as marijuana; toxins from tobacco, alcohol, tea and coffee; environmental pollution due to lead, mercury, cadmium, organochemicals; fungi; food additives; and infectious agents such as rubella, toxoplasma, mycoplasma and syphilis.

Vitamin A is important but excessive doses can actually cause congenital malformations -- any woman intending to become pregnant should monitor her consumption. Choline and vitamin E deficiencies enhance the toxicity of vitamin A. Doctors advise pregnant women or those trying to conceive to refrain from taking any daily supplement that contains more than 7,500 to 10,000 I.U. of vitamin A.

Essential fatty acids are also integral in fetal development, as they are involved in the development of each cell in the body and are specifically important in brain development.

Extreme deficiencies of some nutrients result in infertility and a failure to conceive. It has been shown in animal studies that deficiencies of vitamins B1, B2, B12, folic acid, and vitamin A, and a range of minerals such as iodine, are all associated with an increased risk of congenital abnormalities.

There is a shady area between the extremes of poor nutritional status and infertility, and good nutrition with fertility and normal reproduction where women are still at risk of producing an abnormal child. It is this area that is the target of dietary and nutritional intervention in preconceptional care.

Congenital abnormalities such as neural tube defects, cleft palate and Down's syndrome are associated with deficiencies of several nutrients.

Neural tube defects (NTD) is a condition where the development of the spine and spinal cord is incomplete. Women who have had one NTD baby have a higher risk than average of conceiving another. Studies show that a multivitamin and mineral supplement including folic acid will reduce the risk of the abnormality.

Cleft palates are relatively common. It has been shown that women who have had a previous child with this condition can reduce their risk of having further children with cleft palates by taking vitamin and mineral supplements around the time of conception. In one study, women were given a daily supplement for three months before conception and the first three months of their pregnancies. There was only one recurrence of cleft palate in 85 supplemented pregnancies. There were 15 recurrences among 212 women who did not take the supplements.

As yet, there is no evidence that preconceptional care can prevent Down's syndrome. However, good nutrition will always be a woman's best safeguard against congenital malformation of the fetus and increase the likelihood of it developing normally.

Aside from congenital malformations, the health of the mother before pregnancy is obviously important when it comes to determining whether she will be well during pregnancy.

Parents need to start the preconceptional program at least three to six months before planned conception. Sperm develop over a three-month period, meaning that quality of a man's mature sperm today may have been affected by lifestyle factors three months before.

Obviously, there are measures we can take to safeguard our reproductive health and the well-being of our future children.

The basic recommendations for both sexes for preconceptional care are:

Men -- stop smoking and use of unprescribed drugs, reduce or stop alcohol consumption, improve diet, take protective measure against hazards and toxins in the environment and workplace, use nutritional supplements for deficiencies of nutrients.

Women -- stop smoking, use of non-essential drugs and consumption of alcohol, improve diet, take nutritional supplements (such as vitamin A, iron, folic acid, essential fatty acids andiodine), halt oral contraception, determine food allergies, screen for toxoplasma, rubella, cytomegalovirus and herpes (TORCH), toxic metal screen, handle any health problems, stop all drugs and medicines unless essential.

For good nutrition, both men and women should avoid refined carbohydrates, processed foods and foods with artificial additives, and instead eat an adequate amount of protein, plenty of fresh fruit and vegetables (especially dark-green, leafy vegetables) and whole grains. They should also cut down on consumption of tea and coffee, get regular exercise and try to cope with stress.

The writer is educational staff of Southeast Asian Ministry of Education Organization -- Tropical Medicine, Regional Center for Community Nutrition, University of Indonesia.