Infant mortality in the United States compares unfavorably with that of other countries. In 2018, the infant mortality rate in the U.S. was 5.7 deaths per 1,000 live births. The leading causes of infant deaths include birth defects, preterm birth, and maternal pregnancy complications. Many factors that contribute to poor pregnancy outcomes are already present at the time when prenatal care is initiated, because almost 45% of all pregnancies are unintended. Factors and exposures that can potentially affect fetal development ipclude exposure to various medications, deficiency in folic acid, and uncontrolled chronic disease states. When treating women of childbearing age, it is important to manage them with the goal of optimizing control of chronic conditions and using pregnancy-friendly medications even if no pregnancy is planned for the immediate future.
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