Genomics for Health in Preconception and Prenatal Periods

Abstract

Research, education, advocacy, and anticipatory guidance are needed as women and families obtain more genetic and genomic information before and during pregnancy. All nurses will be involved in helping patients use genetic and genomic information to understand risk and to develop strategies to modify risk, and in translating the expanding array of genomic information to improve birth outcomes.

Preconception Wellness: Differences in Health by Immigrant Status

“…Optimal health before pregnancy includes having a reproductive plan, having a healthy weight, folic acid intake, exercising, healthy nutrition, and abstaining from tobacco and alcohol use [8][9][10][11]. One study that reported on folate levels during the preconception period (folate levels are associated with preventing neural tube defects very early in pregnancy before a woman may even know she is pregnant), found adequate folate levels for Mexican-American and non-Hispanic White women, but not for non-Hispanic Black women [12].…”

Birth defects and preterm birth: Overlapping outcomes with a shared strategy for research and prevention

“…Studies are needed to determine if such a strategy might decrease preterm birth rates as well. Perhaps as we learn more about the differing susceptibility to neural tube defects or preterm birth that varying MTHFR alleles represent, we will be able to use genetic testing to identify susceptibility and provide the basis for personalized preventive recommendations (Dolan et al, 2007a). Similar approaches may become available to identify susceptibility to other common environmental risk factors, such as smoking and infection, that will enhance our ability to provide individualized preconception and prenatal recommendations.…”

The Level of Importance and Level of Confidence that Midwives in the United States Attach to Using Genetics in Practice

“…Since the mapping and sequencing of the human genome was completed in 2003, 1 an immense amount of genetic and genomic information has been discovered. The use of genetics and genomics in the clinical care of pregnant women may expand the diagnosis, treatment, and prevention of human diseases and complications such as preterm birth, preeclampsia, gestational diabetes, multifactorial birth defects, and rare single‐gene disorders 2 . The clinical application of genetic and genomic advances has the potential to transform preconception and pregnancy care and improve pregnancy outcomes 2 .…”

“…The use of genetics and genomics in the clinical care of pregnant women may expand the diagnosis, treatment, and prevention of human diseases and complications such as preterm birth, preeclampsia, gestational diabetes, multifactorial birth defects, and rare single‐gene disorders 2 . The clinical application of genetic and genomic advances has the potential to transform preconception and pregnancy care and improve pregnancy outcomes 2 . Midwives are in a key position to use genetic and genomic information, with the goal of improved maternal and neonatal health 3 …”