This paper explains first, concerning physiological vaginal
first birth (primiparity) why young women should consider delivering her first
baby before the age of 26 (there is a linear association between maternal ages
and healthy deliveries). Second, because of the comparatively large human fetal
brain, nutritional maternal-foetal exchanges are twice those of other mammals
(per body-mass ratios). There is a lack of awareness among young of the very
specific reproductive and sexual strategies of humans as compared to other
mammals. Homo sapiens appeared some 300,000 years ago and our female ancestors
delivered obligatorily vaginally prior to the development of medical
interventions (such as caesarean sections, a safe procedure only since the
1960’s). Furthermore, women are unique among the 4,300 mammal species suffer
from a harmful complication of pregnancy, preeclampsia (especially during a
first pregnancy). But, as the human species has retained the hemochorial
placenta, that first appeared in mammalian evolution, women face the great
challenge of immunological tolerance towards the male partner’s tissues during the
nine months of gestation. This major challenge occurs during the first
pregnancy and tolerance is related to semen exposure prior to conception. In subsequent additional pregnancies,
immunological recognition is largely achieved through the initial pregnancy.
This is why for a first pregnancy (nulliparous woman or multiparous woman with
a new male partner), it is preferable to conceive after a delay of 6 months of
non-barrier contraception before planning conception. Short-term sexual
cohabitation after the couple's constitution (partially recognized male tissue)
may result in incomplete embryo implantation, which can cause problems
including early-onset preeclampsia and/or fetal growth restriction. Third, to
have a baby neither too small, nor too big, women overweight or obese at the
beginning of any pregnancy must gain less weight during the 9 months of
gestation as compared to their leaner counterparts. The optimal gestational
weight gain may be acknowledged during the first prenatal visit, with, a goal
to achieve during the next 7- 8 months of pregnancy.
Author(s) Details:
Pierre-Yves Robillard,
Service de Néonatologie, Centre Hospitalier Universitaire Sud
Réunion, BP 350, 97448 Saint-Pierre Cedex, La Réunion, France and Centre
d’Etudes Périnatales Océan Indien (CEPOI), Centre Hospitalier Universitaire Sud
Réunion, BP 350, 97448 Saint-Pierre cedex, La Réunion, France.
Please see the link here: https://stm.bookpi.org/ANUMS-V5/article/view/13340
