The Dutch national summit on preconception care: a summary of definitions, evidence and recommendations

Temel, Sevilay; Voorst, Sabine F. van; Jong-Potjer, Lieke C de; Waelput, Adja J M; Cornel, Martina C.; Weerd, Sabina Rombout de; Denktaş, Semiha; Steegers, Eric A.P.

doi:10.1007/s12687-014-0204-2

Cited by 44 publications

(49 citation statements)

References 17 publications

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“…[1] The number of PCC risk factors is abundant. [1,2] An example of a PCC measure applicable to every woman is folic acid supplementation. PCC measures depend on the risk profile of the woman or couple.…”

Section: Introductionmentioning

confidence: 99%

Current practice of preconception care by primary caregivers in the Netherlands

Voorst

Plasschaert

Jong-Potjer

et al. 2016

The European Journal of Contraception & Reproductive Health

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Objectives: Over the past decade the value of preconception care (PCC) consultations has been acknowledged. Investments have been made to promote delivery and uptake of PCC consultations in the Dutch primary care setting. We assessed current activities, perceptions and prerequisites for delivery of PCC in primary care. Methods: A questionnaire was compiled and distributed by mail or e-mail among 1682 general practitioners (GPs) and 746 midwives in the Netherlands between 2013 and 2014. Results: The questionnaire was completed by 449 GPs and 250 midwives. While GPs and midwives were frequently asked about preconception risks, explicit requests by patients for a PCC consultation were less frequent. Although caregivers gave information on preconception risk factors, only a minority recommended PCC in the form of a dedicated consultation. Such consultations occurred infrequently. Risk factor assessment varied between GPs and midwives. Respondents' perceptions of PCC consultations, however, were generally positive. A small proportion believed that PCC medicalised pregnancy, and recognised barriers in actively raising the topic of patients' pregnancy wishes. More training, staff, promotion of PCC and adequate reimbursement were prerequisites for future delivery. GPs differed in their opinion of whether they or midwives were primarily responsible for PCC consultations. Midwives, however, saw themselves as responsible for providing PCC consultations. Conclusions: Primary care is underserving prospective parents with regards to PCC consultations. Targets to increase delivery of systematic PCC are: (1) promotion during routine care; (2) increased use of tools; (3) increased collaboration among primary caregivers; (4) reduction of caregivers' negative perceptions; and (5) tailoring PCC consultations to suit women's preferences. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Current practice of preconception care by primary caregivers in the Netherlands

Voorst

Plasschaert

Jong-Potjer

et al. 2016

The European Journal of Contraception & Reproductive Health

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“…Incorporating carrier screening into preconception consultations or raising it during general practice consultations with women of childbearing age, for example, in association with their regular Pap smear, has a number of benefits in that screening would be offered at arguably the most appropriate stage of life (ideally before having their first child), and it would be offered in a very relevant healthcare setting (Metcalfe 2012;Temel et al 2015). However, it should be noted that while the timing and setting of preconception consultations may be ideal for offering carrier screening, it is important that carrier screening is perceived as separate to other health interventions currently offered (such as contraception and Pap smears) so that the introduction of carrier screening does not impact on the uptake of those other interventions.…”

Section: Discussionmentioning

confidence: 99%

“It gives them more options”: preferences for preconception genetic carrier screening for fragile X syndrome in primary healthcare

et al. 2016

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This study aims to explore stakeholder views about offering population-based genetic carrier screening for fragile X syndrome. A qualitative study using interviews and focus groups with stakeholders was undertaken to allow for an indepth exploration of views and perceptions about practicalities of, and strategies for, offering carrier screening for fragile X syndrome to the general population in healthcare settings. A total of 188 stakeholders took part including healthcare providers (n = 81), relatives of people with fragile X syndrome (n = 29), and members of the general community (n = 78). The importance of raising community awareness about screening and providing appropriate support for carriers was emphasized. There was a preference for preconception carrier screening and for providing people with the opportunity to make an informed decision about screening. Primary care was highlighted as a setting which would ensure screening is accessible; however, challenges of offering screening in primary care were identified including time to discuss screening, knowledge about the test and possible outcomes, and the health professionals' approach to offering screening. With the increasing availability of genetic carrier tests, it is essential that research now focuses on evaluating approaches for the delivery of carrier screening programs. Primary healthcare is perceived as an appropriate setting through which to access the target population, and raising awareness is essential to making genetic screening more accessible to the general community.

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“…A set of interventions and/or programmes that aims to identify and enable informed decision-making to modify biomedical, behavioural, and (psycho-) social risks to parental health and the health of their future child, through counselling, prevention and management, emphasizing those factors that must be acted on before conception and in early pregnancy, to have maximal impact and/or choice (3). This definition of PCC is in accordance with the wider concept of PHC.…”

Section: The Content Of Preconception Health Servicesmentioning

confidence: 99%

“…It is estimated that 60 million adolescents give birth each year worldwide, even though globally pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20–29 years (8). The issue of gender-based violence and abuse is intertwined in all mentioned aspects and should be appropriately addressed early as well as later (3,5,7). …”

Section: The Content Of Preconception Health Servicesmentioning

confidence: 99%

Preconception health and care (PHC)—a strategy for improved maternal and child health

Berglund

Lindmark

2016

Upsala Journal of Medical Sciences

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Maternal health status before pregnancy is a decisive factor for pregnancy outcomes and for risk for maternal and infant complications. Still, maternity care does not start until the pregnancy is established and in most low-income settings not until more than half of the pregnancy has passed, which often is too late to impact outcomes. In Western societies preconception care (PCC) is widely recognized as a way to optimize women’s health through biomedical and behavioural changes prior to conception with the aim of improving pregnancy outcomes. But the content of PCC is inconsistent and limited to single interventions or preconception counselling to women with chronic illnesses. It has been suggested that PCC should be extended to preconception health and care (PHC), including interventions prior to pregnancy in order to optimize women’s health in general, and thereby subsequent pregnancy outcomes, the well-being of the family, and the health of the future child. With this definition, almost every activity that can improve the health of girls and women can be included in the concept. In the World Health Report of 2005 a longitudinal approach to women’s wellness and reproductive health was highlighted, and the World Health Organization has proposed a more comprehensive maternal and child health care, also including psychosocial issues and intimate partner violence. The present article gives an overview of the recent literature and discusses contents and delivery of PCC/PHC in Western as well as low-income countries. The article puts special emphasis on why violence against women is an issue for PHC.

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The Dutch national summit on preconception care: a summary of definitions, evidence and recommendations

Cited by 44 publications

References 17 publications

Current practice of preconception care by primary caregivers in the Netherlands

Current practice of preconception care by primary caregivers in the Netherlands

“It gives them more options”: preferences for preconception genetic carrier screening for fragile X syndrome in primary healthcare

Preconception health and care (PHC)—a strategy for improved maternal and child health

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