Josephine R Fowler, Brian W Jack.
Preconception Care.
Med Today Jan ;1(1):22-9.

More than half of all pregnancies worldwide are unplanned. Unplanned pregnancy poses a major risk to both mother and child and ultimately to the society. Unplanned pregnancies contribute to maternal death, neonatal death, pregnancy complications, and neonatal complications. Additionally even among planned and wanted pregnancies, maternal and paternal risks lead to poor perinatal outcomes such as infections diseases, genetic disorders, hemorrhage, poor fetal growth and development and in severe cases maternal and neonatal mortality. Many of these risks can be identified before the onset of pregnancy. Developing a coordinated system to identify medical, psychosocial, behavioral, family planning, and genetic risk prior to pregnancy allows the couple and physician the opportunity to assess the severity of the risk, address the needed changes to improve perinatal outcomes and intervene. Addressing these problems before the onset of pregnancy seems like the opportune time to intervene in areas of preventable disease since that eliminates that particular risk during the pregnancy for both mother and infant (e.g. immunizations for tetanus, hepatitis). In other circumstances such as malnutrition, managing nutritional deficiencies prior to pregnancy would have major impact on both maternal and fetal outcomes. Identifying risks for genetic abnormalities prior to pregnancy allows the couple the opportunity to decide on pregnancy readiness and consider other options for childbearing. Health promotion, risk assessment, and intervention should be a part of every primary care practice. Additionally, women and men of reproductive age should be counseled and evaluated at routine visits for pregnancy readiness and risks and behavioral practices that may affect pregnancy. This is a review article.

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