Where are the Data to Drive Policy Changes for Preconception Health and Health Care?

Posner, Samuel F.; Broussard, Danielle L.; Sappenfield, William M.; Streeter, Nan; Zapata, Lauren B.; Peck, Magda G.

doi:10.1016/j.whi.2008.07.001

Cited by 15 publications

(12 citation statements)

References 11 publications

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“…According to results of different studies, prevalence of unwanted pregnancies in Mashhad has been reported to be 35.8%–37% (10, 11). On the other hand, it should be considered that, in order to develop, implement, and maintain preconception health policies, data are required to be used in line with developing health care standards in health services, while such data are not available in most countries of the world (12), including in Iran. In addition, because the world strategy of pregnancy health should be converted into approaches of each country, implementing plans related to that is the independent right of any nation that should be compatible with national regulation and development priorities of that nation and to be implemented with full respect toward religious, cultural, and moral values of that nation while in harmony with universal human rights (13).…”

Section: Introductionmentioning

confidence: 99%

Experiences of women regarding gaps in preconception care services in the Iranian reproductive health care system: A qualitative study

et al. 2016

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IntroductionDespite the beginnings of preconception care (PCC) delivery around a decade ago in Iran, there are still significant gaps in its service delivery. The purpose of this study was to explore the perceptions and experiences of women as well as midwives toward gaps in PCC delivery in the Iranian reproductive health care system.MethodsIn this exploratory qualitative study, 27 married women and 13 midwives were recruited using purposive sampling from five health centers in Mashhad, Northeast of Iran. Respondents participated in semi-structured, in-depth, individual and focus-group interviews to express their perceptions and experiences about gaps in PCC. Data were analyzed using conventional content analysis adopted by of Graneheim and Lundman (2004) with MAXQDA software.ResultsAnalysis of data revealed four themes: 1) missing men and adolescents from PCC; 2) insufficient PCC package; 3) inadequate PCC strategies; and 4) health care providers’ incompetency.ConclusionIt is recommended to deliver gender-sensitive PCC through addressing couples’ instead of just women’s PCC and to take into account the adolescent girls’ health in order to improve their preconception health. Standardization of protocols and attention of health professionals toward occupational–environmental hazards and sexual and reproductive issues as well as enhancing professional capability of health care providers could improve PCC service delivery.

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Section: Introductionmentioning

confidence: 99%

Experiences of women regarding gaps in preconception care services in the Iranian reproductive health care system: A qualitative study

et al. 2016

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“…3 Building evidence of the role of adverse exposures in early life calls for investigation of the role of preconception and interconceptional health and pregnancy outcomes. 4, 5 Hypothetically, psychosocial and material hardships in childhood and adolescence may ultimately influence pregnancy outcome. 2 …”

Section: Introductionmentioning

confidence: 99%

Childhood Hardship, Maternal Smoking, and Birth Outcomes

Harville¹,

Boynton-Jarrett²,

Power³

et al. 2010

Arch Pediatr Adolesc Med

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“…First, the other studies measured reactivity during pregnancy, while we used pre‐pregnancy stress reactivity. There are good reasons to focus on pre‐pregnancy health: the lack of successful prevention has led to greater focus on preconception health 36–38 . Stress reactivity tends to be fairly stable across long time periods, 24 is reduced during pregnancy 9 and has predicted other outcomes in non‐pregnant adults after long periods of follow‐up 14 .…”

Section: Discussionmentioning

confidence: 99%

“…There are good reasons to focus on pre-pregnancy health: the lack of successful prevention has led to greater focus on preconception health. [36][37][38] Stress reactivity tends to be fairly stable across long time periods, 24 is reduced during pregnancy 9 and has predicted other outcomes in nonpregnant adults after long periods of follow-up. 14 Nonetheless, it is possible that reactivity in pregnancy is more physiologically relevant, perhaps through having direct and immediate effects on the fetal environment.…”

Section: Discussionmentioning

confidence: 99%

Pre-pregnancy stress reactivity and pregnancy outcome

Harville

Gunderson

Matthews

et al. 2010

Paediatric and Perinatal Epidemiology

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Summary Stress has been proposed as a cause of preterm birth (PTB) and small for gestational age (SGA), but stress does not have the same effects on all women. It may be that a woman’s reaction to stress relates to her pregnancy health, and previous studies indicate higher reactivity is associated with reduced birthweight and gestational age. The objective of the study was to examine the relationship between pre-pregnancy cardiovascular reactivity to stress and pregnancy outcome. The sample included 917 women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study who had cardiovascular reactivity measured in 1987–1988 and at least one subsequent singleton live birth within an 18-year period. Cardiovascular reactivity was measured using a video game, star tracing, and cold pressor test. Gestational age and birthweight were based on the women’s self-report, with PTB defined as birth <37 weeks’ gestation and SGA as weight <10th percentile for gestational age. Linear and poisson regression and generalised estimating equations were used to model the relationship between reactivity to stress and birth outcomes with control for confounders. Few associations were seen between reactivity and pregnancy outcomes. Higher pre-pregnancy diastolic blood pressure (adjusted relative risk, 1.14, 95% confidence interval 0.98–1.34) and mean arterial pressure (MAP) reactivity (1.15, 0.98–1.36) were associated with risk of PTB at first pregnancy, while SGA was associated with lower SBP reactivity (0.76, 0.60–0.95). No associations were seen with other measures of reactivity. Contrary to hypothesis, the association between heart rate reactivity and preterm birth in first pregnancy was stronger in whites (aRRs 1.39, 1.03–1.88) than in blacks (1.00, 0.83–1.20; p for interaction=0.08). Similar results were found for mean arterial pressure. No strong associations were found between higher pre-pregnancy stress reactivity and SGA or PTB, and stress reactivity did not have a stronger association with birth outcomes in blacks than whites.

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Where are the Data to Drive Policy Changes for Preconception Health and Health Care?

Cited by 15 publications

References 11 publications

Experiences of women regarding gaps in preconception care services in the Iranian reproductive health care system: A qualitative study

Experiences of women regarding gaps in preconception care services in the Iranian reproductive health care system: A qualitative study

Childhood Hardship, Maternal Smoking, and Birth Outcomes

Pre-pregnancy stress reactivity and pregnancy outcome

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