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Reproductive Health Sep 2014As providing health education, optimizing nutrition, and managing risk factors can be effective for ensuring a healthy outcome for women and her yet un-conceived baby,... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
As providing health education, optimizing nutrition, and managing risk factors can be effective for ensuring a healthy outcome for women and her yet un-conceived baby, external influences play a significant role as well. Alcohol, smoking, caffeine use and other similar lifestyle factors, have now become an integral part of the daily life of most men and women, who use/misuse one or more of these harmful substances regularly despite knowledge of their detrimental effects. The adverse health outcomes of these voluntary and involuntary exposures are of even greater concern in women of child bearing age where the exposure has the potential of inflicting harm to two generations. This paper is examining the available literature for the possible effects of caffeine consumption, smoking, alcohol or exposure to chemicals may have on the maternal, newborn and child health (MNCH).
METHODS
A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception usage of caffeine, tobacco, alcohol and other illicit drugs; and exposure to environmental chemicals and radiant on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.
RESULTS
Heavy maternal preconception caffeine intake of >300 mg/d significantly increase the risk of a subsequent fetal loss by 31% (95% CI: 8-58%). On the other hand, preconception alcohol consumption leads to non-significant 30% increase in spontaneous abortion (RR 1.30; 95% CI: 0.85-1.97). Preconception counselling can lead to a significant decrease in the consumption of alcohol during the first trimester (OR 1.79; 95% CI: 1.08-2.97). Periconception smoking, on the other hand, was found to be associated with an almost 3 times increased risk of congenital heart defects (OR 2.80; 95% CI 1.76-4.47). While the review found limited evidence of preconception environmental exposure on maternal, newborn and child health outcomes, occupational exposure in female radiation workers before conception showed an increased impact in risk of early miscarriages.
CONCLUSION
Identification of substance abuse and environmental history during preconception period provides an opportunity to assist women in reducing major health risks and identify key determinants of healthy pregnancy. Studies have shown that the aversion and prevention of exposure feasibility can play an important role in improving the health of women and their families, however, the results should be interpreted with great caution as there were few studies in each section. Therefore, there is a need for more rigorous studies to test the hypotheses.
Topics: Alcohol Drinking; Caffeine; Environmental Exposure; Female; Humans; Maternal Exposure; Preconception Care; Pregnancy; Pregnancy Complications; Smoking; Substance-Related Disorders
PubMed: 25415846
DOI: 10.1186/1742-4755-11-S3-S6 -
Journal of Medical Internet Research Nov 2016Worldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy... (Review)
Review
BACKGROUND
Worldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy for safeguarding maternal and child health. However, traditional preconception care advice provided by health care professionals (HCPs) within clinic settings is hindered by inadequate resources, suboptimal coverage, and busy clinics. Electronic health (eHealth), which is instrumental in solving problems around scarce health resources, could be of value in overcoming these limitations and be used to improve preconception care and pregnancy outcomes for women with DM.
OBJECTIVE
The objectives were to: (1) identify, summarize, and critically appraise the current methods of providing PCC education; (2) examine the relationship between PCC educational interventions (including use of technology as an intervention medium) on patient and behavioral outcomes; and (3) highlight limitations of current interventions and make recommendations for development of eHealth in this field.
METHODS
Electronic databases were searched using predefined search terms for PCC education in women with type 1 or 2 DM for quantitative studies from 2003 until June 2016. Of the 1969 titles identified, 20 full papers were retrieved and 12 papers were included in this review.
RESULTS
The reviewed studies consistently reported that women receiving educational interventions via health care professionals and eHealth had significantly improved levels of glycosylated hemoglobin (P<.001) with fewer preterm deliveries (P=.02) and adverse fetal outcomes (P=.03). Significant improvements in knowledge (P<.001) and attitudes toward seeking PCC (P=.003) were reported along with reduced barriers (P<.001).
CONCLUSIONS
PCC has a positive effect on pregnancy outcomes for women with DM. However, uptake of PCC is low and the use of eHealth applications for PCC of women with DM is still in its infancy. Initial results are promising; however, future research incorporating mobile phones and apps is needed. Clearly, there is much to be done if the full potential of eHealth PCC to improve obstetric outcomes for women with DM is to be realized.
Topics: Diabetes Mellitus; Female; Humans; Mobile Applications; Preconception Care; Telemedicine
PubMed: 27826131
DOI: 10.2196/jmir.5615 -
African Journal of Primary Health Care... Apr 2022Preconception care (PCC) utilisation is essential to extend and complete the health continuum. However, these services are not yet incorporated into many low-income...
BACKGROUND
Preconception care (PCC) utilisation is essential to extend and complete the health continuum. However, these services are not yet incorporated into many low-income countries' existing maternal health services.
AIM
This study aims to review the current literature on the knowledge, utilisation and provision of PCC.
SETTING
This included women and healthcare workers (HCWs) in Sub-Saharan African (SSA) countries.
METHODS
Arksey and O'Malley's scoping review methodology framework is used in this study. The following databases, Google Scholar, Science Direct, PubMed, Scopus and Dissertation via ProQuest, were searched. Articles that met the eligibility criteria were included in this study.
RESULTS
Out of the 451 retrieved articles, 39 were relevant. In most studies, women's utilisation and HCW's provision of PCC were considered limited. Their knowledge, however, varies between studies, and there were a few studies conducted among women with chronic conditions. Several factors influenced women and HCWs' knowledge, utilisation and provision of PCC, including age, level of education, employment, practice area, resources and knowledge. Preconception care interventions most commonly identified, utilised and provided were HIV testing, counselling and family planning, while preconception folic acid supplementation was the least.
CONCLUSION
The estimates of knowledge and utilisation were suboptimal among women, while provision was the worst affected among HCWs. Gaps exist between the HCW knowledge and practice of PCC. There is a need to promote, prioritise, integrate and optimise the opportunistic provision of PCC in SSA. There is also a need for more studies on PCC provision and utilisation among women with chronic medical conditions.
Topics: Educational Status; Family Planning Services; Female; Health Personnel; Humans; Male; Maternal Health Services; Preconception Care; Pregnancy
PubMed: 35532112
DOI: 10.4102/phcfm.v14i1.3096 -
Journal of Family Medicine and Primary... Feb 2023Preconception health is defined as the physical and psychological well-being of women and men throughout their reproductive life. It is a method that raises healthy... (Review)
Review
Preconception health is defined as the physical and psychological well-being of women and men throughout their reproductive life. It is a method that raises healthy fertility and focuses on activities that persons can take to minimize risks, raise healthy lifestyles, and increase preparation for pregnancy. The purpose of this systematic review study was to assess men's knowledge of preconception health. Electronic databases, including Web of Science, PubMed, Scopus, Sciencedirect, ProQuest, Cochrane, SAGE, Springer, Google Scholar, were searched for published studies from 2000 to March 2021 to identify the studies carried out on men's knowledge of preconception health. The quality assessment was done using the critical appraisal skills program tool for qualitative studies and the Newcastle-Ottawa scale for cross-sectional studies. Of the 1195 references identified in the initial search, 11 studies met the inclusion criteria. Because of the diversity in the study design and the data collection tools used in studies, meta-analysis was impossible. All the studies of the present systematic review found that men's preconception health knowledge is poor. This systematic review showed that men's preconception health knowledge is low. Due to the limited studies of men's knowledge about the importance of optimizing their health before pregnancy, further study of the issue is still required.
PubMed: 37091006
DOI: 10.4103/jfmpc.jfmpc_1090_22 -
Pharmacy (Basel, Switzerland) Oct 2021: Community pharmacist-led interventions are effective in improving health outcomes; however, their impact in improving preconception and pregnancy health is not clear.... (Review)
Review
: Community pharmacist-led interventions are effective in improving health outcomes; however, their impact in improving preconception and pregnancy health is not clear. This study evaluated the effectiveness of community pharmacist-led interventions which aimed to improve health outcomes of preconception and pregnant women. A systematic review of the literature, consistent with PRISMA guidelines, was performed. Five electronic databases were searched up to February 2021. Four studies, three in pregnant women and one in preconception women, were identified. The studies focused on improving micronutrient status and smoking cessation. The studies increased knowledge about, and use of, iron supplements, and improved iron status and smoking cessation rates in pregnant women, while improving knowledge regarding, and increasing the use of, preconception folic acid. The studies were ranked as weak to moderate quality. This review provides preliminary evidence for the potential benefit of community pharmacist-led interventions to improve the health of women before and during pregnancy.
PubMed: 34698302
DOI: 10.3390/pharmacy9040171 -
Canadian Journal of Public Health =... Nov 2017The objective of this systematic review was to assess the effects of preconception health interventions, delivered to individuals of reproductive age in public health... (Review)
Review
OBJECTIVES
The objective of this systematic review was to assess the effects of preconception health interventions, delivered to individuals of reproductive age in public health and community settings, on reproductive, maternal, and child health outcomes.
METHODS
A search of Ovid MEDLINE, CINAHL, EMBASE, PsychINFO, Scopus, Gender Studies Database, and SocINDEX from July 1999 through July 2016 was performed. We included studies that reported original data, used an interventional study design, included reproductive-aged women or men, were written in English, and were published in peer-reviewed journals. Two reviewers independently used standardized instruments for data extraction and quality assessment. A narrative synthesis was performed.
SYNTHESIS
Twelve studies met the inclusion criteria. These studies included randomized controlled trials and quasi-experimental, pre-post, and time-series designs. Most studies were conducted in the United States; all but one study included only women. Interventions were mainly educational initiatives focused on nutrition, immunization, and lifestyle behaviours and were delivered in a single contact. The studies reported positive effects on health knowledge (n = 9), behaviour change (n = 4), and health outcomes (n = 1). Study quality was weak (n = 11) or moderate (n = 1), with limitations related to selection bias, blinding, data collection methods, and participant attrition.
CONCLUSION
To develop a comprehensive, standardized approach to preconception health promotion and care in Canada, there is a clear need for high-quality research evaluating the effectiveness of preconception health interventions. Studies should use a health equity lens that includes all individuals of reproductive age and addresses the broad determinants of preconception health.
Topics: Canada; Community Health Services; Delivery of Health Care; Health Promotion; Humans; Preconception Care; Program Evaluation; Public Health; Randomized Controlled Trials as Topic
PubMed: 29120310
DOI: 10.17269/cjph.108.6029 -
Maternal & Child Nutrition Apr 2020The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated...
The aim of this study is to determine the level of adherence to dietary guidelines among men and women during preconception, and pregnant women, and factors associated with adherence. Searches were conducted in CINAHL, AMED, EMBASE, and Maternity and Infant Care from inception to March 2018. Observational studies assessing the primary outcome (adherence to dietary guidelines and/or nutritional recommendations) and/or secondary outcome (factors associated with adherence) were eligible. Study quality was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional studies. Men or women (aged ≥18 years) who identified as trying/intending to conceive or were pregnant. Eighteen studies were included. The quality of studies was fair (44%) to good (56%). Most studies indicated preconceptual and pregnant women do not meet recommendations for vegetable, cereal grain, or folate intake. Pregnant women did not meet iron or calcium intake requirements in 91% and 55% of included studies, respectively, and also exceeded fat intake recommendations in 55% of included studies. Higher level education was associated with improved guideline adherence in pregnant women, whereas older age and non-smoking status were associated with greater guideline adherence in preconceptual and pregnant women. The findings of this review suggest that preconceptual and pregnant women may not be meeting the minimum requirements stipulated in dietary guidelines and/or nutritional recommendations. This could have potential adverse consequences for pregnancy and birth outcomes and the health of the offspring. Major knowledge gaps identified in this review, which warrant further investigation, are the dietary intakes of men during preconception, and the predictors of guideline adherence.
Topics: Female; Humans; Male; Nutrition Policy; Nutritional Physiological Phenomena; Patient Compliance; Preconception Care; Pregnancy; Prenatal Care
PubMed: 31793249
DOI: 10.1111/mcn.12916 -
BMC Public Health Jun 2024Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies,... (Review)
Review
BACKGROUND
Preconception health has the potential to improve parental, pregnancy and infant outcomes. This scoping review aims to (1) provide an overview of the strategies, policies, guidelines, frameworks, and recommendations available in the UK and Ireland that address preconception health and care, identifying common approaches and health-influencing factors that are targeted; and (2) conduct an audit to explore the awareness and use of resources found in the scoping review amongst healthcare professionals, to validate and contextualise findings relevant to Northern Ireland.
METHODS
Grey literature resources were identified through Google Advanced Search, NICE, OpenAire, ProQuest and relevant public health and government websites. Resources were included if published, reviewed, or updated between January 2011 and May 2022. Data were extracted into Excel and coded using NVivo. The review design included the involvement of the "Healthy Reproductive Years" Patient and Public Involvement and Engagement advisory panel.
RESULTS
The searches identified 273 resources, and a subsequent audit with healthcare professionals in Northern Ireland revealed five additional preconception health-related resources. A wide range of resource types were identified, and preconception health was often not the only focus of the resources reviewed. Resources proposed approaches to improve preconception health and care, such as the need for improved awareness and access to care, preconceptual counselling, multidisciplinary collaborations, and the adoption of a life-course approach. Many behavioural (e.g., folic acid intake, smoking), biomedical (e.g., mental and physical health conditions), and environmental and social (e.g., deprivation) factors were identified and addressed in the resources reviewed. In particular, pre-existing physical health conditions were frequently mentioned, with fewer resources addressing psychological factors and mental health. Overall, there was a greater focus on women's, rather than men's, behaviours.
CONCLUSIONS
This scoping review synthesised existing resources available in the UK and Ireland to identify a wide range of common approaches and factors that influence preconception health and care. Efforts are needed to implement the identified resources (e.g., strategies, guidelines) to support people of childbearing age to access preconception care and optimise their preconception health.
Topics: Humans; Preconception Care; Ireland; Female; United Kingdom; Health Policy; Practice Guidelines as Topic; Pregnancy
PubMed: 38909211
DOI: 10.1186/s12889-024-19188-0 -
Reproductive Health Apr 2021Preconception care is the provision of biomedical, behavioural, and social health interventions provided to women and couples before conception. However, in Ethiopia,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Preconception care is the provision of biomedical, behavioural, and social health interventions provided to women and couples before conception. However, in Ethiopia, little is known and practised to support preconception care. Therefore, this study aimed to assess women's knowledge and utilisation of preconception care and its associated factors in Ethiopia using systematic review and meta-analysis.
METHOD
In the current meta-analysis, variables were searched from different electronic database systems, which included PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were analysed by using STATA 14 statistical software. I tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled knowledge and utilisation of preconception care.
RESULTS
Thirteen full-text studies were included. The pooled prevalence of knowledge and utilisation of preconception care among women in Ethiopia was 30.95% and 16.27% respectivelly. Secondary education (OR = 2.78, 95% CI,2.01-3.85), college and above (OR = 5.05, 95% CI,2.70-9.44), and antenatal care (OR = 3.89, 95% CI, 1.69-8.98) were significantly associated with knowledge level whereas; age (OR = 2.43, 95% CI, 1.30-4.53) and knowledge on preconception care (OR = 3.95, 95% CI,2.35-6.62) were positively associated with utilisation of preconception.
CONCLUSIONS
Women's level of knowledge and utilisation of preconception care was significantly low. Educational status and antenatal care follow-up were factors shown to affect knowledge of preconception care. Age and having a sound knowledge of preconception care indicated a significant association towards utilisation of preconception care. Thus, integrating preconception care strategies and policies that can address all the components of preconception care services with other maternal and child health services will be essential when designing effective implementation strategies to improve preconception care uptake. Besides this, advocating for better education for women, awareness creation, and increasing antenatal care services are essential. Prospero registration: CRD42020218062.
Topics: Adolescent; Cross-Sectional Studies; Educational Status; Ethiopia; Female; Health Knowledge, Attitudes, Practice; Humans; Preconception Care; Pregnancy; Prenatal Care; Reproductive Health; Reproductive Health Services; Residence Characteristics; Young Adult
PubMed: 33858438
DOI: 10.1186/s12978-021-01132-9 -
European Journal of Clinical Nutrition Jul 2023Pre-eclampsia can lead to maternal and neonatal complications and is a common cause of maternal mortality worldwide. This review has examined the effect of micronutrient... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pre-eclampsia can lead to maternal and neonatal complications and is a common cause of maternal mortality worldwide. This review has examined the effect of micronutrient supplementation interventions in women identified as having a greater risk of developing pre-eclampsia.
METHODS
A systematic review was performed using the PRISMA guidelines. The electronic databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials were searched for relevant literature and eligible studies identified according to a pre-specified criteria. A meta-analysis of randomised controlled trials (RCTs) was conducted to examine the effect of micronutrient supplementation on pre-eclampsia in high-risk women.
RESULTS
Twenty RCTs were identified and supplementation included vitamin C and E (n = 7), calcium (n = 5), vitamin D (n = 3), folic acid (n = 2), magnesium (n = 1) and multiple micronutrients (n = 2). Sample size and recruitment time point varied across studies and a variety of predictive factors were used to identify participants, with a previous history of pre-eclampsia being the most common. No studies utilised a validated prediction model. There was a reduction in pre-eclampsia with calcium (risk difference, -0.15 (-0.27, -0.03, I = 83.4%)), and vitamin D (risk difference, -0.09 (-0.17, -0.02, I = 0.0%)) supplementation.
CONCLUSION
Our findings show a lower rate of pre-eclampsia with calcium and vitamin D, however, conclusions were limited by small sample sizes, methodological variability and heterogeneity between studies. Further higher quality, large-scale RCTs of calcium and vitamin D are warranted. Exploration of interventions at different time points before and during pregnancy as well as those which utilise prediction modelling methodology, would provide greater insight into the efficacy of micronutrient supplementation intervention in the prevention of pre-eclampsia in high-risk women.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Calcium; Calcium, Dietary; Dietary Supplements; Pre-Eclampsia; Pregnant Women; Premature Birth; Vitamin D; Vitamins; Preconception Care
PubMed: 36352102
DOI: 10.1038/s41430-022-01232-0