Preconception care: a 2008 update.

Centers for Disease Control and Prevention, NCBDDD, Atlanta, Georgia 30333, USA.
Current opinion in obstetrics & gynecology (Impact Factor: 2.37). 01/2009; 20(6):581-9. DOI: 10.1097/GCO.0b013e328317a27c
Source: PubMed

ABSTRACT This study reviews what we know about preconception care, its definition, goals, and content; the science behind the recommended interventions; opportunities for implementing preconception care; and the challenges facing its implementation.
There is solid scientific evidence that many interventions will improve pregnancy outcomes if delivered before pregnancy or early in pregnancy. Experts continue to explore the most effective means for implementing preconception care, taking into consideration issues related to policy, finance, public health practice, research/surveillance, and consumer and provider education.
Over the past 4 years, there has been renewed interest and a great emphasis on preconception health and healthcare as alternative and additional approaches to counter the persistent increasing incidence in adverse pregnancy outcomes in the United States. Following the publication of the 'Recommendations to Improve Preconception Health and Healthcare' in 2006, many state and local health departments initiated programs to implement the recommendations. Several countries such as Canada, Belgium, and the Netherlands have also started to implement preconception care programs. There are many opportunities for promoting preconception health and providing preconception care; however, making preconception care a standard practice continues to face many barriers.

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    ABSTRACT: Background To date, there is a lack of evidence to suggest that a systematic and coordinated approach to prepregnancy care might make a difference.AimsTo evaluate whether women who receive preconception care through a structured approach will be more likely to be healthy around the time of conception compared with women who plan their pregnancy but have not been exposed to preconception care.MethodsA case control study was undertaken of women who attended the preconception care service and subsequently conceived, received maternity care and gave birth at Mater Health Services Brisbane between January 2010 and January 2013. Pregnancy information and birth outcomes for each woman who attended the service were matched with those of three women who reported that they had planned their pregnancy but did not attend the service. Records were matched for prepregnancy BMI, age, parity, prepregnancy smoking status and number of health conditions.ResultsPregnant women who attended preconception care were more likely to have received adequate peri-conceptual folate, to report being vaccinated against influenza and hepatitis B, to have consulted with a specialist with the specific aim of optimising a pre-existing health condition and to report less weight gain up until booking. Preterm birth and hypertensive disorders of pregnancy were less common amongst women who had attended preconception care, and there were trends towards a decreased incidence of gestational diabetes, LGA and fetal anomalies.Conclusion These preliminary data provide some optimism that a comprehensive preconception care service may positively influence maternal and neonatal outcomes.
    Australian and New Zealand Journal of Obstetrics and Gynaecology 07/2014; 54(6). DOI:10.1111/ajo.12224 · 1.62 Impact Factor
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    ABSTRACT: Background Maternal behavior before and after conception affects maternal and child health. Limited awareness of adolescents in preconception health may be addressed through school education. The aim of this intervention is to assess preconception health awareness among adolescents in Lebanese high schools and to test the effectiveness of a one-time educational session in improving preconception knowledge. Methods The intervention consisted of a 30-minute educational session about good practices in preconception health, developed by the National Collaborative Perinatal Neonatal Network’s (NCPNN) research team. A convenience sample of high school Lebanese students in grades 10 to 12, aged 14 to 26 years old, from 70 private and public schools in all six Lebanese provinces, participated in the intervention in 2011 and 2012. A multiple-choice questionnaire administered prior to and 2 months after the session was used to assess knowledge improvement among the students. Results A total of 7,290 students were enrolled. After the session, mean scores of correct answers increased from 4.36 to 6.42 out of 10, representing a 47.2% improvement (p < 0.001). The percent of correct answers increased for all the questions regarding health practices (p < 0.001). The greatest improvement was observed for questions about Trisomy 21, folic acid intake and toxoplasmosis with percentages improvement of 96%, 172% and 83% respectively. Being female or in private school was a significant predictor of higher scores in both pre-test and post-test (p < 0.001). Conclusions Awareness campaigns in schools increased the preconception health knowledge among high school students. We recommend expanding the scope of this intervention into universities in Lebanon. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-774) contains supplementary material, which is available to authorized users.
    BMC Public Health 07/2014; 14(1):774. DOI:10.1186/1471-2458-14-774 · 2.32 Impact Factor
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    ABSTRACT: Purpose. To understand how social and structural contexts shape individual risk, vulnerability, and interconception health-related behaviors of African-American women. Approach or Design. A longitudinal ethnographic study was conducted. Setting. The study was conducted in Philadelphia, Pennsylvania. Participants. The sample included 19 African-American women who were participants in the intervention group of a randomized clinical trial of interconceptional care. Method. Data were collected through interaction with participants over a period of 6 to 12 months. Participant observation, structured and unstructured interviews, and Photovoice were used to obtain data; grounded theory was used for analysis. The analysis was guided by intersectional theory. Results. Social disadvantage influenced health and health care–seeking behaviors of African-American women, and the disadvantage centered on the experience of racism. The authors identify seven experiences grounded in the interactions among the forces of racism, class, gender, and history that may influence women's participation in and the effectiveness of preconception and interconception health care. Conclusion. African-American women's health and wellness behaviors are influenced by an experience of racism structurally embedded and made more virulent by its intersection with class, gender, and history. These intersecting forces create what may be a unique exposure that contributes significantly to the proximal determinants of health inequities for African-American women. Health promotion approaches that focus on the individual as the locus of intervention must concomitantly unravel and address the intertwining structural forces that shape individual circumstance in order to improve women's interconceptional health and to reduce disparities. (Am J Health Promot 2013;27[3 Supplement]:eS32–eS42.)
    American journal of health promotion: AJHP 01/2013; 27(3):S32-42. DOI:10.4278/ajhp.120117-QUAL-43 · 2.37 Impact Factor


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May 20, 2014