Genetics issues in preconception health care.

Genetics is an important area of focus for the preconception visit (Table 4). Folic acid should be recommended for all women. The genetic and pregnancy history should be evaluated for clues to a genetic disorder. Preconception screening and counseling are available for many diseases that are indicated in the family history. Screening may be offered for sickle cell anemia, thalassemia, Tay Sachs disease, and cystic fibrosis in the appropriate population groups. Older couples should be counseled about their increased risks for having complications during pregnancy and for having children with genetic disorders.