FIGO Preconception Checklist: Preconception care for mother and baby

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Abstract

The preconception period is a unique and opportunistic time in a woman's life when she is motivated to adopt healthy behaviors that will benefit her and her child, making this time period a critical “window of opportunity” to improve short‐ and long‐term health. Improving preconception health can ultimately improve both fetal and maternal outcomes. Promoting health before conception has several beneficial effects, including an increase in seeking antenatal care and a reduction in neonatal mortality. Preconception health is a broad concept that encompasses the management of chronic diseases, including optimal nutrition, adequate consumption of folic acid, control of body weight, adoption of healthy lifestyles, and receipt of appropriate vaccinations. Use of the FIGO Preconception Checklist, which includes the key elements of optimal preconception care, will empower women and their healthcare providers to better prepare women and their families for pregnancy.

Synopsis

Preconception care should be provided to all women of childbearing age by healthcare professionals during routine visits, whatever their pregnancy intentions.

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Most cited references 61

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Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants

Regina Guthold, Gretchen Stevens, Leanne Riley … (2018)

Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends.

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Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?

Zulfiqar Bhutta, Jai K Das, Rajiv Bahl … (2014)

Progress in newborn survival has been slow, and even more so for reductions in stillbirths. To meet Every Newborn targets of ten or fewer neonatal deaths and ten or fewer stillbirths per 1000 births in every country by 2035 will necessitate accelerated scale-up of the most effective care targeting major causes of newborn deaths. We have systematically reviewed interventions across the continuum of care and various delivery platforms, and then modelled the effect and cost of scale-up in the 75 high-burden Countdown countries. Closure of the quality gap through the provision of effective care for all women and newborn babies delivering in facilities could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1·325 million neonatal deaths annually by 2020 at an estimated running cost of US$4·5 billion per year (US$0·9 per person). Increased coverage and quality of preconception, antenatal, intrapartum, and postnatal interventions by 2025 could avert 71% of neonatal deaths (1·9 million [range 1·6-2·1 million]), 33% of stillbirths (0·82 million [0·60-0·93 million]), and 54% of maternal deaths (0·16 million [0·14-0·17 million]) per year. These reductions can be achieved at an annual incremental running cost of US$5·65 billion (US$1·15 per person), which amounts to US$1928 for each life saved, including stillbirths, neonatal, and maternal deaths. Most (82%) of this effect is attributable to facility-based care which, although more expensive than community-based strategies, improves the likelihood of survival. Most of the running costs are also for facility-based care (US$3·66 billion or 64%), even without the cost of new hospitals and country-specific capital inputs being factored in. The maximum effect on neonatal deaths is through interventions delivered during labour and birth, including for obstetric complications (41%), followed by care of small and ill newborn babies (30%). To meet the unmet need for family planning with modern contraceptives would be synergistic, and would contribute to around a halving of births and therefore deaths. Our analysis also indicates that available interventions can reduce the three most common cause of neonatal mortality--preterm, intrapartum, and infection-related deaths--by 58%, 79%, and 84%, respectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health

Judith Stephenson, Nicola Heslehurst, Jennifer Hall … (2018)

A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from high, low and middle income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours. Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high and lower income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents. Numerous studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little impact on maternal and newborn health outcomes. There have been comparatively few attempts at preconception diet and lifestyle intervention. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that this is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception. We propose novel definitions of the preconception period relating to embryo development and to action at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable disease. Alongside continued efforts to reduce smoking, alcohol and obesity in the population, we call for heightened awareness of preconception health, particularly regarding diet and nutrition. Importantly health professionals should be alerted to ways of identifying women who are planning a pregnancy.

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Author and article information

Journal

Title: International Journal of Gynecology & Obstetrics

Abbreviated Title: Intl J Gynecology & Obste

Publisher: Wiley

ISSN (Print): 0020-7292

ISSN (Electronic): 1879-3479

Publication date Created: April 2024

Publication date (Electronic): March 2024

Publication date (Print): April 2024

Volume: 165

Issue: 1

Pages: 1-8

Affiliations

[1 ] Department of Obstetrics and Gynecology Sant'Anna University Hospital Torino Italy

[2 ] FIGO Committee on Well Woman Health Care London UK

[3 ] UCD Perinatal Research Centre, National Maternity Hospital University College Dublin Dublin Ireland

[4 ] FIGO Committee on the Impact of Pregnancy on Long‐Term Health London UK

[5 ] Institute of Developmental Sciences University of Southampton Southampton UK

[6 ] FIGO Division of Maternal and Newborn Health London UK

[7 ] Department of Genes and Environment Norwegian Institute of Public Health Oslo Norway

[8 ] Department of Obstetrics and Gynecology Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden

[9 ] Department of Obstetrics and Gynecology Sahlgrenska University Hospital, University of Gothenburg Gothenburg Sweden

[10 ] The Environmental Health Leadership Foundation California USA

Article

DOI: 10.1002/ijgo.15446

SO-VID: a4235371-de75-49da-8d80-b12098d93ba7

License:

http://creativecommons.org/licenses/by-nc/4.0/

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