Long term health conditions

• The National Institute for Clinical Excellence (NICE) recommends that women with pre-exisiting diabetes should access specialist services prior to conception.
• Tight control of blood sugars reduces the chance of miscarriage, stillbirth, neonatal death, macrosomic babies and congenital malformation.
• The use of a higher dose of folate (5mg daily) should be clarified with her GP/diabetes specialist. See 'Folic acid supplements'.

• Women with hepatitis B or C may pass the infection on to their baby and so should discuss preconception care with their specialist.
• Current Hepatitis C treatment options are unsuitable for use in pregnancy due to concerns over teratogenicity.
• Pregnancy also needs to be avoided for four months following maternal use of ribavarin and seven months after paternal use.

• HIV positive women and HIV negative women with an HIV positive male partner should discuss their plans for pregnancy well in advance with their HIV specialist in order to reduce risk of HIV transmission and to optimise healthy outcomes.
• A woman with HIV can be safely treated with antiretroviral therapy (ART) which can reduce the HIV transmission rate to 0.27%.
• The international birth register of women on ART has not seen an increase in birth defects in women treated with ART.
• A HIV negative woman with a HIV positive male partner who does not have a consistent undetectable viral load may be considered for HIV pre exposure prophylaxis (PrEP) to reduce risk of HIV transmission.

• Women with previous or existing mental health problems are more likely to experience problems during and after pregnancy.
• Dealing with the underlying causes of poor mental health and treating mental health problems before pregnancy can help prevent negative pregnancy outcomes for both mother and baby.

• Women with RA are normally under specialist care and a multi disciplinary approach to pregnancy planning is vital.

• The aim is to keep the woman seizure free during the pregnancy, whilst trying to reduce the possible teratogenic risk to the fetus from anti-epileptic drugs (AED). See 'Medication not uncommonly used in women of reproductive age'.
• It is important to refer women with seizure disorders to their GP and/or specialists for pre conception advice.
• The use of a higher dose of folate (5mg daily) should be clarified with her GP/epilepsy specialist. See 'Folic acid supplements'.

• Maternal and fetal outcomes are improved when the patient is on stable therapy and the disease has been quiescent for at least six months prior to the pregnancy.
• SLE can involve the heart and vascular system, lungs and kidneys.
• Women with SLE are normally under specialist care and a multi disciplinary approach to pregnancy planning is vital.

Including:

• asthma
• cardiovascular disease
• eating disorders
• hypertension
• blood clots
• phenylketonuria
• renal disease
• thrombophilia
• thyroid disease