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Cited by 186Prenatal Substance Exposure EffectsPregnancy and Medication ImpactMaternal and Neonatal Healthcare

Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure

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Lassi, Zohra S, Imam, Ayesha M, Dean, Sohni V, Bhutta, Zulfiqar A·2014·Reproductive Health
DOI 10.1186/1742-4755-11-s3-s6PMC PMC4196566
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Abstract

INTRODUCTION: As providing health education, optimizing nutrition, and managing risk factors can be effective for ensuring a healthy outcome for women and her yet un-conceived baby, external influences play a significant role as well. Alcohol, smoking, caffeine use and other similar lifestyle factors, have now become an integral part of the daily life of most men and women, who use/misuse one or more of these harmful substances regularly despite knowledge of their detrimental effects. The adverse health outcomes of these voluntary and involuntary exposures are of even greater concern in women of child bearing age where the exposure has the potential of inflicting harm to two generations. This paper is examining the available literature for the possible effects of caffeine consumption, smoking, alcohol or exposure to chemicals may have on the maternal, newborn and child health (MNCH). METHODS: A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception usage of caffeine, tobacco, alcohol and other illicit drugs; and exposure to environmental chemicals and radiant on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. RESULTS: Heavy maternal preconception caffeine intake of >300 mg/d significantly increase the risk of a subsequent fetal loss by 31% (95% CI: 8-58%). On the other hand, preconception alcohol consumption leads to non-significant 30% increase in spontaneous abortion (RR 1.30; 95% CI: 0.85-1.97). Preconception counselling can lead to a significant decrease in the consumption of alcohol during the first trimester (OR 1.79; 95% CI: 1.08-2.97). Periconception smoking, on the other hand, was found to be associated with an almost 3 times increased risk of congenital heart defects (OR 2.80; 95% CI 1.76-4.47). While the review found limited evidence of preconception environmental exposure on maternal, newborn and child health outcomes, occupational exposure in female radiation workers before conception showed an increased impact in risk of early miscarriages. CONCLUSION: Identification of substance abuse and environmental history during preconception period provides an opportunity to assist women in reducing major health risks and identify key determinants of healthy pregnancy. Studies have shown that the aversion and prevention of exposure feasibility can play an important role in improving the health of women and their families, however, the results should be interpreted with great caution as there were few studies in each section. Therefore, there is a need for more rigorous studies to test the hypotheses.

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  • Lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception.

    “Evidence suggests that lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception [4–7].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [5]

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  • An unhealthy diet, lifestyle behaviours and exercising pattern are progressively becoming part of Western society, including among a high percentage of women in their reproductive age.

    “Our results are relevant since an unhealthy diet, lifestyle behaviours and exercising pattern are progressively becoming part of Western society, including among a high percentage of women in their reproductive age [5, 6, 16].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [5]

    The Discussion (page unavailable) says a growing number of women in their reproductive years consume caffeine, alcohol, tobacco or illicit drugs. The Introduction (page unavailable) also reports substantial alcohol use and smoking among US women. These passages support the lifestyle-behaviour portion, but do not address unhealthy diet or exercise patterns, or establish a trend across Western society. (LLM, conf=0.87)

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  1. Review Manager (RevMan). [computer program]. Version 5.0: 2008 Copenhagen: Nordic Cochrane Collaboration

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Authors
Lassi, Z. S., Imam, A. M., Dean, S. V., & Bhutta, Z. A.
Affiliations
Aga Khan University (PK)
Corresponding author
Bhutta, Zulfiqar A
ORCID
Venue
Reproductive Health
Publisher
Springer Science and Business Media LLC
Published
2014-09-26
Volume
11
Issue
S3
Pages
S6-S6
ISSN
1742-4755 (ISSN-L)
DOI
10.1186/1742-4755-11-s3-s6
PMC
PMC4196566
OpenAlex
W2146057142
Cited by
186
References
100
Citations by year
2026: 10 · 2025: 12 · 2024: 16 · 2023: 16 · 2022: 17 · 2021: 24 · 2020: 20 · 2019: 15 · 2018: 16 · 2017: 20 · 2016: 12 · 2015: 5 · 2014: 3
FWCI
2.01
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Reproductive Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
preconception care, maternal caffeine intake, illicit drug use, environmental chemical exposure, radiation exposure, fetal death, miscarriage, congenital heart disease, preconception counseling, maternal, newborn and child health, occupational radiation exposure, women of reproductive age, substance use prevention, pregnancy risk factors, lifestyle risk factors
MeSH terms
Alcohol Drinking, Caffeine, Environmental Exposure, Female, Humans, Pregnancy, Pregnancy Complications, Smoking, Preconception Care, Maternal Exposure, Substance-Related Disorders

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