Effectiveness of preconception interventions in primary care: a systematic review

Nishadi N. Withanage, Jessica R. Botfield, Sonia Srinivasan, Kirsten I. Black, Danielle Mazza

Research output: Contribution to journalReview ArticleResearchpeer-review

6 Citations (Scopus)

Abstract

Background Primary care-based preconception care (PCC) has the potential to improve pregnancy outcomes, but the effectiveness is unclear. Aim To evaluate the effectiveness of primary care-based PCC delivered to reproductiveaged females and/or males to improve health knowledge, reduce preconception risk factors, and improve pregnancy outcomes. Design and setting A systematic review of primary care-based PCC. Method Ovid MEDLINE, Cochrane CENTRAL, Embase, Web of Science, Scopus, and CINAHL were searched for randomised controlled trials (RCTs) published between July 1999 and May 2021. Two reviewers independently evaluated article eligibility and quality. Results Twenty-eight articles reporting on 22 RCTs were included. All but one focused on females. Interventions included brief education (single session) (n = 8), intensive education (multiple sessions) (n = 9), supplementary medication (n = 7), and dietary modification (n = 4). Brief education improved health knowledge in females (n = 3) and males (n = 1), reduced alcohol/ tobacco consumption (n = 2), and increased folate intake (n = 3). Intensive education reduced spontaneous pregnancy loss (n = 1), alcoholexposed pregnancies (n = 2), and increased physical activity (n = 2). Supplementary medication increased folate intake (n = 4) and dietary modification reduced pre-eclampsia (n = 1) and increased birth weight (n = 1). Only eight articles reported on pregnancy outcomes, with a range of interventions used; of these, four reported improvements in pregnancy outcomes. Most RCTs were of low quality (n = 12). Conclusion Primary care-based PCC including brief and intensive education, supplementary medication, and dietary modification are effective in improving health knowledge and reducing preconception risk factors in females, although there is limited evidence for males. Further research is required to determine whether primary care-based PCC can improve pregnancy outcomes.

Original languageEnglish
Pages (from-to)E865-E872
Number of pages8
JournalBritish Journal of General Practice
Volume72
Issue number725
DOIs
Publication statusPublished - Dec 2022

Keywords

  • general practice
  • pre-pregnancy care
  • preconception care
  • pregnancy outcomes
  • primary care

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