American Journal of Obstetrics and Gynecology
SupplementThe clinical content of preconception care: an overview and preparation of this supplement
Section snippets
Selection of topics to be reviewed
The workgroup identified a set of specific criteria to assist in choosing among the clinical topics to be reviewed. The resulting selection criteria comprised the following items: (1) There is a good chance that the health of the mother or the infant will be improved if the condition is identified and addressed before pregnancy; (2) the burden of suffering and prevalence of the condition are sufficient to justify screening and treatment; (3) the condition is detectable in clinical care in
Health promotion and risk reduction
The clinical workgroup retained the organizational structure that was promulgated by the Expert Panel on the Content of Prenatal Care,3 which suggested that the components of preconception care include the provision of health education that is individualized to a woman's or couple's needs (health promotion), a thorough and systematic identification of risks (risk assessment), and the initiation of actions to address those risks (interventions) with women and men of reproductive age to reduce
Presentation of each topic and recommendations for clinical care
The information that is provided about each topic was standardized based on the format that was developed by the United States Preventive Services Task Force.5 Each topic is reviewed with the following structure: (1) The burden of suffering, which includes the prevalence and importance of the target condition; (2) the accuracy of the screening methods that are available to detect the condition either in primary or specialty settings; (3) the effectiveness and availability of current treatments
Strength of recommendations and quality of the evidence
The strength of the recommendation and the quality of the evidence for each of the clinical components were then rated by the authors and editors, and consensus was reached. The criteria that were used were adapted from those criteria that were used in the report of the US Preventive Services Task Force Guide of Clinical Preventive Services.5 The following criteria were used to determine the quality of the evidence and the strength of the recommendation:
Summary of preconception recommendations
The Table provides a summary list of the topics that were reviewed, the consensus recommendation for each topic, the strength of the recommendation, and the rating of the quality of the evidence. Together, we believe that these recommendations represent the current state of the art in defining the evidence-based best practices in preconception care. These recommendations also identify the areas of preconception care in which more research is needed. We expect these recommendations to change as
References (5)
- et al.
Where is the “W” in MCH?
Am J Obstet Gynecol
(2008) Recommendations for improving preconception health and health care: United States: a report of the CC/ATSDR Preconception Care Workgroup and the Select Panel on Preconception Care
MMWR Morb Mortal Weekly Rep
(2006)
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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflict of Interest: Brian W. Jack, MD; Hani Atrash, MD, MPH; Merry-K Moos, BSN, FNP, MPH; Julie O'Donnell, MPH; and Kay Johnson, MPH, EdM have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH, is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.