The American College of Obstetricians and Gynecologists recommend that all health encounters during a woman’s reproductive years, particularly those that are a part of preconception care, should include counseling on appropriate health behaviors to optimize pregnancy outcomes and prevent maternal mortality.
Preconception care is defined as a set of interventions that aim to identify and modify biomedical, behavioral and social risks to the woman’s health or pregnancy outcome through prevention and management. Certain steps should be taken before conception or early in pregnancy to maximize health outcomes. Consider the following clinical issues. 2
Checklist of preconception care topics
Education:
- Smoking, alcohol abuse and other drug use
- Folic acid supplementation, 400 mcg daily as a standard of care
Counseling:
- Sexually transmitted infections including HIV
- Family planning and pregnancy spacing
- Healthy body weight and diet
- Importance of oral health
- Increased risk of hepatitis C in those with tattoos and/or body piercings
- Lead and other environmental and/or occupational exposures
- Genetic disorders (including cystic fibrosis and sickle cell genotypes)
