Conference Paper

Environmental Reproductive Nursing Consultation: Health from the Beginning

  • Fundació Hospital d'Olot i Comarcal de la Garrotxa
  • Hospital Clinico Universitario Virgen de la Arrixaca-IMIB, Murcia, Spain
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Background: The Environmental Reproductive Nursing consultation involves a clinical consultation focused on detection, intervention and prevention of exposures to environmental hazards during the critical periods of fetus development (spermatogenesis and pregnancy) that pays special attention to legal and illegal drugs. Methods: The consultation is supplemented with an ultrasound at 12 weeks of gestation. The goals of the consultation are to detect and reduce environmental exposures that can negatively a ect the health of the fetus (or embryo) and to prevent recurrent diseases. In addition, to establish “environmental risk labels “ in those pregnancies where the exposures have been severe enough to trigger diseases related to those exposures and allow us to make diagnoses prenatally or in the rst months of life. The working tool is called the “hoja verde” and consists of a set of basic and concise questions that allow us to identify and manage/reduce environmental risk factors at critical periods of pregnancy (including spermatogenesis) and breastfeeding. We examine socioeconomic factors, reproductive history, ionizing radiation, drugs/herbalism/homeopathy, occupational exposures, smoking, illegal drugs, alcohol, pesticides and environmental perception of their community. Ethical approval was granted by La Hoja Verde’s ethics committee. Results: Of the first 1,500 couples with risk during early pregnancy (2009/2012), we found a rate of 34.9% of maternal smoking, 45.4% of paternal smoking, 59.4% of maternal alcohol consumption during early pregnancy, 85% of paternal alcohol consumption during spermatogenesis, and 10.1% of fetuses exposed to illegal drugs during early pregnancy. In the successive years, the data presented showed a signi cant decrease in women who drink some alcohol in early pregnancy, a signi cant decrease in the amount of alcohol that the couples consume and a decrease in the number of newborns with congenital heart disease associated with intrauterine exposure to ethanol. Conclusions: The Environmental Reproductive Nursing consultation is a clinical consultation/practice that allows us to identify, address and prevent environmental risk factors that would be otherwise go unnoticed. The training in this type of discipline/consultation is critical in order to increase the quality of pregnancy, health of the pregnant couple, as well as the health of the upcoming newborn.

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