Recommendations to improve preconception health and health care -- United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care

Abstract

"This report provides recommendations to improve both preconception health and care. The goal of these recommendations is to improve the health of women and couples, before conception of a first or subsequent pregnancy. Since the early 1990s, guidelines have recommended preconception care, and reviews of previous studies have assessed the evidence for interventions and documented the evidence for specific interventions. CDC has developed these recommendations based on a review of published research and the opinions of specialists from the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. The 10 recommendations in this report are based on preconception health care for the U.S. population and are aimed at achieving four goals to 1) improve the knowledge and attitudes and behaviors of men and women related to preconception health; 2) assure that all women of childbearing age in the United States receive preconception care services (i.e., evidence-based risk screening, health promotion, and interventions) that will enable them to enter pregnancy in optimal health; 3) reduce risks indicated by a previous adverse pregnancy outcome through interventions during the interconception period, which can prevent or minimize health problems for a mother and her future children; and 4) reduce the disparities in adverse pregnancy outcomes. The recommendations focus on changes in consumer knowledge, clinical practice, public health programs, health-care financing, and data and research activities. Each recommendation is accompanied by a series of specific action steps and, when implemented, can yield results within 2-5 years. Based on implementation of the recommendations, improvements in access to care, continuity of care, risk screening, appropriate delivery of interventions, and changes in health behaviors of men and women of childbearing age are expected to occur. The implementation of these recommendations will help achieve Healthy People 2010 objectives. The recommendations and action steps are a strategic plan that can be used by persons, communities, public health and clinical providers, and governments to improve the health of women, their children, and their families. Improving preconception health among the approximately 62 million women of childbearing age will require multistrategic, action-oriented initiatives" - p. 1Introduction -- -- Preconception Health and Care -- Healthy People 2000/2010 Objectives for Improving Preconception Health and Guidelines for Preconception Care -- Preconception Risks Associated with Adverse Pregnancy Outcomes -- Preconception Prevention and Intervention -- -- Context and Frame Work for Recommendations -- How the Recommendations were Developed -- Recommendations to Improve Preconception Health -- Recommendations -- Conclusion References -- Appendix: External Partner Organizationsprepared by Kay Johnson, Samuel F. Posner, Janis Biermann , Jose\ucc? F. Cordero, Hani K. Atrash, Christopher S. Parker, Sheree Boulet, Michele G. Curtis."April 21, 2006."Cover title."The material in this report originated in the National Center on Birth Defects and Developmental Disabilities, Jose\ucc? F. Cordero, MD, Director; and the Office of Program Development, Hani K. Atrash, MD, Associate Director; and the National Center for Chronic Disease Prevention and Health Promotion, Janet Collins, PhD, Director, and the Division of Reproductive Health, John Lehnherr, Director. " - p. 1Also available via the World Wide Web.Includes bibliographical references (p. 16-21)