New research has underlined the importance of good health before conception for women - and probably men.
Published in the British Journal of General Practice, the Monash University-led systematic review investigated primary care-based preconception care interventions, including education, supplementary medication and dietary modification. Researchers found preconception care was effective in improving health knowledge and reducing preconception risk factors such as alcohol consumption and smoking in women.
This is the first review to consider the role of health providers and the importance of preconception care for both women and men. Findings highlight the need for more research to determine whether primary care-based preconception care can improve pregnancy outcomes, and more evidence about the possible benefits for men.
"Since modifiable risk factors including smoking and alcohol consumption may also impact men's reproductive health and sperm quality, preconception care directed towards reproductive-aged men may also improve pregnancy outcomes," the researchers wrote. Lead author Nishadi Withanage, from SPHERE - The Centre of Research Excellence in Sexual and Reproductive Health for Women, based in the Monash School of Public Health and Preventive Medicine, said preconception care interventions in community and hospital settings are known to reduce risk factors and improve pregnancy outcomes but there is limited evidence on their effectiveness in primary care settings globally. "Not everyone is aware of the need for optimal health during the preconception phase; they generally prioritise this during pregnancy," Ms Withanage said. "This systematic review demonstrates that preconception care interventions delivered in primary care settings are effective in reducing risk factors and improving health knowledge." Preconception care includes interventions before conception that modify risk factors and reduce adverse pregnancy outcomes such as low birth weight, spontaneous abortion, and preterm birth. Interventions may include preconception counselling or education, dietary modification and supplementary medication. Ms Withanage hopes the new review will help primary care providers in general practices (GPs, nurses, midwives) and enhance their understanding of the effectiveness of preconception care. She said this could also help raise awareness among reproductive aged men/women of the importance of optimal health during the preconception period. "Receiving health information during the preconception phase is very important in reducing risk factors like alcohol consumption, smoking and improving overall health," she said. "But there is currently limited evidence that preconception care provided to men improves health as most studies have focused on women." Ms Withanage urged those planning a pregnancy to talk with their GP about preconception health.
"They will need to initiate the discussion when they meet with their GPs," she said.
"They should ask the GP for resources to help them improve their knowledge about how they can maintain optimal health during the preconception phase."
Visit Monash Lens to read Ms Withanage's Family Planning: The Importance of Preconception Health.
Read the full paper in the British Journal of General Practice, A systematic review of the effectiveness of preconception interventions in primary care.
