-
Public Health Research & Practice Oct 2022To explore opportunities to change increasing weight gain trajectories for women during their reproductive lives, focusing on optimising health before pregnancy. Type of...
OBJECTIVE
To explore opportunities to change increasing weight gain trajectories for women during their reproductive lives, focusing on optimising health before pregnancy. Type of program: Identifying optimal policies, health promotion and health services to support preconception health for women (with a focus on achieving a healthy weight).
METHODS
Narrative description of changing policies and approaches for improving preconception health.
RESULTS
Preconception preventive health priorities have been clearly determined globally and nationally. However, further rigorous research for effective interventions to facilitate healthy weight and other aspects of preconception health, alongside effective policies and strategies for implementing these interventions, remains potentially important. Barriers for women, their partners, families, communities and health professionals must be overcome and enablers fostered. The inclusion of preconception lifestyle health to tackle maternal and childhood obesity as a key priority of the World Health Organization as well as in the Australian National obesity strategy 2022-2032 are steps in the right direction.
LESSONS LEARNT
Improving health across the life course requires a whole of system, integrated and equitable approach to health promotion, healthcare and policy. This includes integrating education, work, community environments, and health professionals to engage girls and young women well before pregnancy, to optimise their health. National coordination to determine core indicators and systems to evaluate and monitor change has been shown to help internationally and can be applied in Australia.
Topics: Australia; Child; Delivery of Health Care; Female; Humans; Pediatric Obesity; Policy; Preconception Care; Pregnancy
PubMed: 36220563
DOI: 10.17061/phrp3232227 -
Seminars in Reproductive Medicine Jul 2022Preconception health affects fertility, pregnancy, and future health outcomes but public awareness of this is low. Our aims were to rank priorities for preconception... (Review)
Review
Preconception health affects fertility, pregnancy, and future health outcomes but public awareness of this is low. Our aims were to rank priorities for preconception care (PCC), develop strategies to address these priorities, and establish values to guide future work in preconception healthcare in Australia. A Delphi technique involved two rounds of online voting and mid-round workshops. Inputs were a scoping review of PCC guidelines, a priority setting framework and existing networks that focus on health. During July and August, 2021, 23 multidisciplinary experts in PCC or social care, including a consumer advocate, completed the Delphi technique. Ten priority areas were identified, with health behaviors, medical history, weight, and reproductive health ranked most highly. Six strategies were identified. Underpinning values encompassed engagement with stakeholders, a life course view of preconception health, an integrated multi-sectorial approach and a need for large scale collaboration to implement interventions that deliver impact across health care, social care, policy and population health. Priority populations were considered within the social determinants of health. Health behaviors, medical history, weight, and reproductive health were ranked highly as PCC priorities. Key strategies to address priorities should be implemented with consideration of values that improve the preconception health of all Australians.
Topics: Australia; Delivery of Health Care; Delphi Technique; Female; Humans; Preconception Care; Pregnancy; Reproductive Health
PubMed: 35760312
DOI: 10.1055/s-0042-1749683 -
International Journal of Environmental... Apr 2021Despite adverse pregnancy outcomes for women with overweight or obesity, preconception guidelines for achieving optimal wellness for women contemplating pregnancy... (Review)
Review
Despite adverse pregnancy outcomes for women with overweight or obesity, preconception guidelines for achieving optimal wellness for women contemplating pregnancy regarding the risks of overweight or obesity are varied based upon national affiliation. The aim of this study was to synthesize the best evidence related to preconception counseling and care focused on overweight or obesity provided to women of reproductive age. An integrative review of original studies was conducted. PubMed, Cumulative Index in Nursing and Allied Health Literature, Ovid, Scopus, Web of Science, and Embase were included. Full-text, data-based articles were searched from 2009 to 2018, with reviews and synthesis completed in 2019 and 2020. Of 8703 initial articles, 31 articles remained in the review. Quality assessment and level of evidence were evaluated based upon criteria from the Joanna Briggs Institute and the Johns Hopkins Nursing Evidence-Based Practice Quality Guide. The level of evidence for the majority of studies was non-experimental but they were of good quality with appropriate methods, samples and relevant results. Limited attention and interest in preconception counseling regarding risks of overweight or obesity by health care professionals were noted, which may contribute to women's unawareness of these risks on preconception health.
Topics: Female; Health Personnel; Humans; Obesity; Overweight; Preconception Care; Pregnancy; Pregnancy Outcome
PubMed: 33925982
DOI: 10.3390/ijerph18094582 -
Seminars in Reproductive Medicine Jul 2022Challenges remain with the implementation of preconception care, as many women do not plan their pregnancies and clinicians do not initiate preconception consultations.... (Review)
Review
Challenges remain with the implementation of preconception care, as many women do not plan their pregnancies and clinicians do not initiate preconception consultations. However, the interconception period may present a more opportune time to address health issues that impact on pregnancy outcomes and may influence future conceptions. It is also an important time to focus on pregnancy complications that may influence a person's health trajectory. This review discusses the evidence pointing to a need for greater attention on interconception health and focuses on five areas of care that may be particularly important in affecting equitable access to good care before a subsequent pregnancy: interpregnancy intervals, contraception, weight, nutrition, and gestational diabetes follow-up. Several programs internationally have developed models of care for interconception health and this review presents one such model developed in the United States that explicitly seeks to reach vulnerable populations of women who may otherwise not receive preconception care.
Topics: Contraception; Female; Humans; Preconception Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome; United States
PubMed: 35901810
DOI: 10.1055/s-0042-1744517 -
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 -
BMC Pregnancy and Childbirth Jan 2022Preconception care helps to close the gaps in a continuum of care. It is of paramount importance to reduce maternal and child adverse pregnancy outcomes, increase the...
BACKGROUND
Preconception care helps to close the gaps in a continuum of care. It is of paramount importance to reduce maternal and child adverse pregnancy outcomes, increase the utilization of services such as antenatal care, skilled delivery care, and post-natal care, and improve the lives of future generations. Therefore, a validated instrument is required. The purpose of this study was to develop and validate the preconception care improvement scale (PCIS) in a resource-limited setting.
METHODS
A mixed-method study was carried out from 02, March to 10, April 2019 in Manna district, Oromia region, Ethiopia to test the reliability and validity of the scale. Items were generated from literatures review, in-depth interviews with different individuals, and focused group discussions with women of reproductive age groups. A pretested structured questionnaire was used and a survey was conducted among 623 pregnant women in the district. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 software and data were analyzed for internal consistency and validity using reliability analysis and factor analysis.
RESULTS
The PCIS has 17 items loaded into six factors: Substance-related behaviors, screening for common non-communicable and infectious diseases, micronutrient supplementation and vaccination, seeking advice, decision and readiness for conception, and screening for sexually transmitted diseases. Factor analysis accounted for 67.51% of the observed variance. The internal consistency (Cronbach's alpha) of the scale was 0.776. Diversified participants of the qualitative study and experts' discussions assured the face and content validity of the scale. Factor loading indicated the convergent validity of the scale. Three of the PCIS subscale scores had a positive and significant association with the practice of preconception care and antenatal care visits, which confirmed the predictive validity of the scale.
CONCLUSION
The PCIS exhibited good reliability, face validity, content validity, convergent validity, and predictive validity. Thus, the scale is valid and helps to improve preconception care, especially in resource-limited settings.
Topics: Ethiopia; Female; Health Knowledge, Attitudes, Practice; Humans; Preconception Care; Psychometrics; Quality Improvement; Reproducibility of Results; Surveys and Questionnaires
PubMed: 35016627
DOI: 10.1186/s12884-021-04338-8 -
Women and Birth : Journal of the... Sep 2020A recognised gap exists between current and recommended practices in the provision of lifestyle advice and weight management support for women across preconception and...
PROBLEM
A recognised gap exists between current and recommended practices in the provision of lifestyle advice and weight management support for women across preconception and pregnancy care.
BACKGROUND
Preconception and pregnancy are critical stages for promoting healthy maternal lifestyles and obesity prevention. Co-design is a novel approach with the potential to strengthen existing models of care to facilitate the implementation of clinical practice guidelines promoting preconception and pregnancy health, especially in relation to preconception weight management and preventing excessive gestational weight gain.
AIM AND METHODS
The aims of this discussion paper are to (i) define co-design in the context of preconception and pregnancy care, (ii) outline key considerations when planning co-design initiatives and (iii) describe co-design opportunities in preconception and pregnancy care for promoting women's health and obesity prevention.
DISCUSSION
While several definitions of co-design exist, one critical element is the meaningful involvement of all key stakeholders. In this discussion, we specifically identified the involvement of women and expanding the role of practice nurses in primary care may assist to overcome barriers to the provision of healthy lifestyle advice and support for women during preconception. Co-designing pregnancy care will involve input from women, nurses, midwives, obstetricians, allied health and administration and management staff. Additional attention is required to co-design care for women considered most at-risk.
CONCLUSION
There is potential to enhance current provision of preconception and pregnancy care using co-design. Nursing and midwifery professions are active across both preconception and pregnancy and therefore, they have an important role to play.
Topics: Adult; Family Planning Services; Female; Healthy Lifestyle; Humans; Midwifery; Obesity; Preconception Care; Pregnancy; Prenatal Care; Primary Health Care; Women's Health
PubMed: 31812498
DOI: 10.1016/j.wombi.2019.11.005 -
Nursing For Women's Health Apr 2021Planned and unplanned pregnancies are occurring among transgender men. Although the literature highlights the fact that many transgender men retain their reproductive... (Review)
Review
Planned and unplanned pregnancies are occurring among transgender men. Although the literature highlights the fact that many transgender men retain their reproductive pelvic organs and desire pregnancy, there is a dearth of information on best practices and standards of care guiding perinatal care for this population. A literature review was conducted to explore the reproductive health needs of transgender men related to reproductive desires, contraception, family planning, fertility preservation, pregnancy, birth, and lactation. Findings show that pregnant and birthing transgender men are reporting feelings of invisibility, isolation, and loneliness in highly gendered perinatal care environments. A lack of gender-affirming perinatal environments and experienced providers is contributing to the avoidance of care by transgender men and further discrimination in an already marginalized population. More research attention is needed to understand the reproductive health needs of pregnant and birthing transgender men and to optimize the care they receive.
Topics: Breast Feeding; Contraception; Female; Gender Identity; Humans; Lactation; Male; Parturition; Preconception Care; Pregnancy; Reproductive Health; Transgender Persons
PubMed: 33651985
DOI: 10.1016/j.nwh.2021.01.006 -
Rheumatic Diseases Clinics of North... Aug 2023Family planning in women with vasculitis requires an interdisciplinary approach. This article summarizes recommendations and guidance for each phase of family planning... (Review)
Review
Family planning in women with vasculitis requires an interdisciplinary approach. This article summarizes recommendations and guidance for each phase of family planning in persons with vasculitis including preconception counseling, birth control, pregnancy, and breastfeeding. Pregnancy complications are presented by category of vasculitis with accompanying diagnostic and therapeutic recommendations. Birth control and assisted reproductive technology options are reviewed with special considerations for women who are high risk or have a history of blood clots. This article can be used as a clinical reference for reproductive discussions in all patients with vasculitis.
Topics: Pregnancy; Humans; Female; Counseling; Vasculitis; Preconception Care
PubMed: 37331740
DOI: 10.1016/j.rdc.2023.03.009 -
Journal of Women's Health (2002) Feb 2023This report provides an overview of the unique reproductive health issues facing women with congenital heart defects (CHDs) and of the clinical care and professional... (Review)
Review
This report provides an overview of the unique reproductive health issues facing women with congenital heart defects (CHDs) and of the clinical care and professional guidelines on contraception, preconception care, and pregnancy for this population. It describes Centers for Disease Control and Prevention (CDC) activities related to surveillance of reproductive health issues among females with CHDs. It also describes CDC's work bringing awareness to physicians who provide care to adolescents and women with CHDs, including obstetrician/gynecologists, about the need for lifelong cardiology care for their patients with CHDs.
Topics: Adolescent; Female; Humans; Pregnancy; Contraception; Heart Defects, Congenital; Preconception Care; Reproductive Health
PubMed: 36757282
DOI: 10.1089/jwh.2022.0513