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PloS One 2021As the studies show, in every minute in the world, 380 women become pregnant and 190 face unplanned or unwanted pregnancies; 110 experience pregnancy-related... (Meta-Analysis)
Meta-Analysis
BACKGROUND
As the studies show, in every minute in the world, 380 women become pregnant and 190 face unplanned or unwanted pregnancies; 110 experience pregnancy-related complications, and one woman dies from a pregnancy-related cause. Preconception care is one of the proven strategies for the reduction in mortality and decreases the risk of adverse health effects for the woman, fetus, and neonate by optimizing maternal health services and improves woman's health. Therefore, this study aimed to estimate the pooled prevalence of utilization of preconception of care and associated factors in Africa.
METHODS
Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL, and manually on Google Scholar. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed by the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software.
RESULT
From 249,301 obtained studies, 28 studies from 3 African regions involving 13067 women included in this Meta-analysis. The overall pooled prevalence of utilization of preconception care among pregnant women in Africa was found to be 18.72% (95% CI: 14.44, 23.00). Knowledge of preconception care (P = <0.001), preexisting medical condition (P = 0.045), and pregnancy intention (P = 0.016) were significantly associated with the utilization of preconception care.
CONCLUSION
The results of this meta-analysis indicated, as one of best approaches to improve birth outcomes, the utilization of preconception care is significantly low among mothers in Africa. Therefore, health care organizations should work on strategies to improve preconception care utilization.
Topics: Africa; Facilities and Services Utilization; Female; Humans; Mothers; Preconception Care; Pregnancy; Pregnant Women; Quality of Health Care
PubMed: 34297760
DOI: 10.1371/journal.pone.0254935 -
Maternal and Child Health Journal Mar 2022Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. PCC services are minimally available and...
OBJECTIVES
Preconception care (PCC) is a recognised strategy for optimising maternal health and improving maternal and neonatal outcomes. PCC services are minimally available and not fully integrated into maternal health services in Nigeria. This study explored perceptions about PCC services among health care providers in Ibadan, Nigeria.
METHODS
Using a qualitative case study design the perspectives of 26 health care providers-16 specialist physicians and nine nurses covering 10 specialties at the primary, secondary and tertiary health care levels was explored. In-depth interviews were digitally recorded, transcribed verbatim and analysed on MAXQDA using thematic analysis.
RESULTS
Almost all participants stated that PCC services should be offered at all three levels of health care with referral when needed between lower and higher levels. Participants stated that although all people of reproductive age would benefit from PCC, those who had medical problems like hypertension, sickle cell disease, diabetes and infertility would benefit more. Participants opined that delayed health care seeking observed in the community may influence acceptability of PCC especially for people without known pre-existing conditions. All specialist physicians identified the relevance of PCC to their practice. They identified potential benefits of PCC including opportunity to prepare for pregnancy to ensure positive pregnancy outcomes.
CONCLUSIONS FOR PRACTICE
Preconception care is perceived as important for promoting positive pregnancy outcomes in people with known medical problems and is relevant to different specialities of medical practice. Provision of the service will require establishment of guidelines and uptake will depend on acceptability to community members who will benefit from the service.
Topics: Female; Health Personnel; Humans; Infant, Newborn; Nigeria; Patient Acceptance of Health Care; Preconception Care; Pregnancy; Qualitative Research
PubMed: 34982335
DOI: 10.1007/s10995-021-03305-1 -
American Family Physician Mar 2020Family physicians should use a proactive, integrated, patient-centered approach to sexual health that includes, but is not limited to, disease identification and...
Family physicians should use a proactive, integrated, patient-centered approach to sexual health that includes, but is not limited to, disease identification and treatment. Successfully delivering positive, affirming, nonjudgmental sexual health care requires intentionally creating safe spaces for all patients. Physician and staff training could include identifying individual implicit bias around sexuality and sexual topics, adverse childhood experiences, and trauma-informed care. Models such as the five Ps (partners, practices, protection from sexually transmitted diseases, past history of sexually transmitted diseases, and pregnancy plans) and ExPLISSIT (extended permission giving, limited information, specific suggestions, and intensive therapy) can help physicians organize their approach to sexual health histories. Preventive health strategies include screening for sexually transmitted diseases and sexually transmitted infections, screening for and offering preexposure prophylaxis for HIV, behavioral counseling to reduce the risk of sexually transmitted infections, and preconception care for all patients, including gender-diverse patients. Because sexual health concerns are quite common, family physicians should be prepared to discuss topics such as erectile dysfunction, dyspareunia, and arousal disorders.
Topics: Anti-HIV Agents; Counseling; HIV Infections; Humans; Medical History Taking; Physician-Patient Relations; Physicians, Family; Pre-Exposure Prophylaxis; Preconception Care; Sexual Behavior; Sexual Health; Sexually Transmitted Diseases
PubMed: 32109033
DOI: No ID Found -
Endocrinology and Metabolism Clinics of... Sep 2019Fertility rates in classic congenital adrenal hyperplasia caused by 21-hydroxylase deficiency are substantially decreased for various reasons, including hormonal,... (Review)
Review
Fertility rates in classic congenital adrenal hyperplasia caused by 21-hydroxylase deficiency are substantially decreased for various reasons, including hormonal, anatomic, psychosocial, and psychosexual causes. However, fecundity is comparable with the general population. Under optimal hormone replacement, the course and outcome of pregnancies is also good. This article summarizes successful gestational management, including preconceptional considerations, adjustment of hormone replacement during pregnancy, delivery and lactation, as well as the prevention of adrenal crises. In nonclassic 21-hydroxylase deficiency, preconceptional low-dose hydrocortisone replacement normalizes the otherwise increased miscarriage rate. Pregnancy reports in rarer forms of congenital adrenal hyperplasia are summarized as well.
Topics: Adrenal Hyperplasia, Congenital; Female; Fertility; Hormone Replacement Therapy; Humans; Hydrocortisone; Preconception Care; Pregnancy; Pregnancy Complications
PubMed: 31345527
DOI: 10.1016/j.ecl.2019.05.011 -
PloS One 2022Preconception care is biomedical, social, and behavioural care provided for a woman or couple before conception occurs or throughout their reproductive year. In...
Knowledge, attitude, and practice of preconception care and associated factors among obstetric care providers working in public health facilities of West Shoa Zone, Ethiopia: A cross-sectional study.
Preconception care is biomedical, social, and behavioural care provided for a woman or couple before conception occurs or throughout their reproductive year. In Ethiopia, it's reported that the majority of health care providers had poor knowledge and practice of preconception care. The institution-based cross-sectional study was conducted among 359 obstetric care providers to assess knowledge, attitude, and practice of preconception care in West Shoa Zone, Ethiopia. A stratified, simple random sampling technique selected five hospitals, 46 health centers, and study participants. Pretested and structured questionnaires were used to collect data. Data were entered into Epidata and exported to SPSS for analysis. Bivariate and multivariate logistic regressions were employed to identify an association between the independent predictors and the outcome variables. In this study, 173(48.2%) and 124(34.5%) of the obstetric care providers had good knowledge and practice of preconception care, respectively. Two-thirds 255(71%) of providers had a favorable attitude toward preconception care. The odds of having good knowledge were higher among Midwives' providers [AOR: 2.03, 95%CI: 1.09-3.77] and had training on HIV testing [AOR: 3.5, 95%CI: 1.9-6.4]. The presence of a library [AOR: 1.7, 95%CI: 1.04-2.85] and internet access [AOR: 3.4, 95%CI: 2.0-5.8] in working health facility had a higher odds of good knowledge about preconception. Degree and above holders [AOR: 3.1, 95%CI: 1.5-6.1] also had higher odds of good preconception knowledge than diploma holders. Similarly, the odds of having good practice of preconception care were higher among health care providers: who did screening for reproductive life plans [AOR: 3.7, 95%CI:1.8-7.4], worked in maternity and child health unit [AOR:4.2,95%CI:2.0-8.6], perceive all health facilities should give preconception care services [AOR:2.3,95%CI:1.2-4.3], and perceive all health care providers should provide preconception services [AOR:3.0, 95%CI: 1.7-5.5]. This study found that more than half of obstetric care providers' had poor knowledge, favorable attitude, and poor practice of preconception care. Provision of training, carrier development, and installation of internet and library services should be enhanced.
Topics: Child; Cross-Sectional Studies; Ethiopia; Female; Health Facilities; Health Knowledge, Attitudes, Practice; Humans; Preconception Care; Pregnancy; Surveys and Questionnaires
PubMed: 35913932
DOI: 10.1371/journal.pone.0272316 -
Journal of Developmental Origins of... Apr 2022Initiatives to optimise preconception health are emerging following growing recognition that this may improve the health and well-being of women and men of reproductive... (Review)
Review
Initiatives to optimise preconception health are emerging following growing recognition that this may improve the health and well-being of women and men of reproductive age and optimise health in their children. To inform and evaluate such initiatives, guidance is required on indicators that describe and monitor population-level preconception health. We searched relevant databases and websites (March 2021) to identify national and international preconception guidelines, recommendations and policy reports. These were reviewed to identify preconception indicators. Indicators were aligned with a measure describing the prevalence of the indicator as recorded in national population-based data sources in England. From 22 documents reviewed, we identified 66 indicators across 12 domains. Domains included wider (social/economic) determinants of health; health care; reproductive health and family planning; health behaviours; environmental exposures; cervical screening; immunisation and infections; mental health, physical health; medication and genetic risk. Sixty-five of the 66 indicators were reported in at least one national routine health data set, survey or cohort study. A measure of preconception health assessment and care was not identified in any current national data source. Perspectives from three (healthcare) professionals described how indicator assessment and monitoring may influence patient care and inform awareness campaign development. This review forms the foundation for developing a national surveillance system for preconception health in England. The identified indicators can be assessed using national data sources to determine the population's preconception needs, improve patient care, inform and evaluate new campaigns and interventions and enhance accountability from responsible agencies to improve preconception health.
Topics: Child; Cohort Studies; Early Detection of Cancer; Female; Humans; Information Storage and Retrieval; Male; Preconception Care; Pregnancy; Uterine Cervical Neoplasms
PubMed: 34085623
DOI: 10.1017/S2040174421000258 -
European Journal of Vascular and... Aug 2020
Review
Topics: Aortic Aneurysm; Female; Genetic Counseling; Genetic Predisposition to Disease; Heredity; Humans; Pedigree; Preconception Care; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 32409015
DOI: 10.1016/j.ejvs.2020.03.052 -
Obstetrics and Gynecology Clinics of... Sep 2019An investment in assuring the health of women, before pregnancy, can reap improved health for women, children, and their families. A paradigm shift of health must occur... (Review)
Review
An investment in assuring the health of women, before pregnancy, can reap improved health for women, children, and their families. A paradigm shift of health must occur if perinatal outcomes are to improve, moving beyond reactive care to preventive or preconception care. Preconception health is centered on an assumption a woman is planning on becoming pregnant. But for many women, pregnancy is unplanned and medical conditions may have a negative impact on the trajectory of pregnancy and health. A new paradigm focusing on prevention and wellness can prepare women for lifelong health and healthy perinatal outcomes.
Topics: Adolescent; Ethnicity; Female; Folic Acid; Humans; Infant; Mental Health; Preconception Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Socioeconomic Factors; United States; Women's Health; Young Adult
PubMed: 31378284
DOI: 10.1016/j.ogc.2019.04.001 -
Women's Health (London, England) 2021Provision of preconception care is significantly affected by the health care provider's knowledge of preconception care. In Ethiopia, preconception care is rare, if even...
BACKGROUND
Provision of preconception care is significantly affected by the health care provider's knowledge of preconception care. In Ethiopia, preconception care is rare, if even available, as part of maternal health care services. Thus, this study aimed to determine the level of knowledge of preconception care and associated factors among health care providers working in public health facilities in Eastern Ethiopia.
METHODS
A multicenter cross-sectional study was conducted from 1 March to 1 April 2020. A simple random sampling technique was used to select a total of 415 maternal health care providers. We utilized a structured, pretested, and self-administered questionnaire to collect data. Data were entered into EpiData (version 3.1) and exported to STATA (version 16) for analysis. Descriptive statistics and bivariate and multivariate logistic regression analyses were performed. All covariates with a p value ⩽0.20 in bivariate logistic regression were entered into a multivariate logistic regression analysis to control the confounding variables; variables with a p value <0.05 were considered statistically significant.
RESULTS
Out of 410 respondents, 247 (60.2%; 95% confidence interval: 55.4-65.1) had good knowledge of preconception care. Having an educational level of Bachelor of Science degree and above (adjusted odds ratio: 6.97, 95% confidence interval: 3.85-12.60), 5 or more years work experience (adjusted odds ratio: 2.60, 95% confidence interval: 1.52-4.49), working in a hospital (adjusted odds ratio: 2.50, 95% confidence interval: 1.25-4.99), reading preconception care guidelines (adjusted odds ratio: 3.06, 95% confidence interval: 1.40-6.68), and training on preconception (adjusted odds ratio: 2.90, 95% confidence interval: 1.37-6.15) were significantly associated with good knowledge of preconception care.
CONCLUSIONS AND RECOMMENDATIONS
Three out of five maternal health care providers in this study had good knowledge of preconception care. Facilitating continuous refreshment training and continuous professional development for health workers, preparing comprehensive preconception care guidelines for health institutions, and reading preconception care guidelines were highly recommended.
Topics: Cross-Sectional Studies; Ethiopia; Female; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Preconception Care; Pregnancy; Public Health
PubMed: 34553661
DOI: 10.1177/17455065211046139 -
PloS One 2022Preconception care is highly important in reducing a number of adverse pregnancy outcomes and helps to improve maternal health. Preconception care optimizes women's...
BACKGROUND
Preconception care is highly important in reducing a number of adverse pregnancy outcomes and helps to improve maternal health. Preconception care optimizes women's health and improves pregnancy outcomes. It is a cost-effective first-line preventive strategy for birth defects. However, preconception care utilization in Ethiopia was very low. Studies on these issues are limited in Ethiopia in general and in Mizan-Aman town in particular.
OBJECTIVE
To assess preconception care utilization and associated factors among reproductive age women in Mizan-Aman town, Bench-Sheko Zone, Southwest Ethiopia.
METHODS
A community based cross-sectional study design was employed from April 16 to May 26, 2020 in Mizan-Aman town. The total study participants were 624 reproductive age women. Data were collected by using pre-tested interviewer administered questionnaires and entered into Epi-data version 3.1 then exported to STATA version 14 and analyzed accordingly. Univeriate and Bivariable analysis was done by analysis of variance (ANOVA) and independent t-test. Multivariable statistical analysis using generalized linear regression model (GLM) approach was used to classify factors of preconception care utilization. Since our response variable is measured in terms of count variable, we used a Poisson regression model with a log link function. Finally, Statistical significance between dependent and independent variables were assessed by odds ratios and 95% confidence intervals.
RESULTS
Overall, 28.6% of the women receipt atleast one item of preconception care while only 1.5% were taken the whole recommended components of preconception care services. The most common item received in the study area was taking micronutrient supplementation (18.5%). Age of women, educational status, husbands educational status, husbands occupation, wealth status, distance from the health facility, waiting time to get services, planning to pregnancy, age at first pregnancy, previous ANC use, Previous PNC use, adverse pregnancy experience, women's knowledge of preconception care, and attitude on preconception care were determinants of preconception service utilization.
CONCLUSIONS
Preconception care component utilization was lower as compare with recommended service with different disparities. Multipurpose tailored strategies which incorporate a woman with no formal education, poor knwledge on preconception care,never take maternal services previously and distant from health facility could improve preconception care service utilization. Advocative strategies on preconception care component and planning pregnancy may elicite more women to use the services of preconception care.
Topics: Amantadine; Cross-Sectional Studies; Ethiopia; Female; Health Knowledge, Attitudes, Practice; Humans; Preconception Care; Pregnancy
PubMed: 35984828
DOI: 10.1371/journal.pone.0273297