A Systematic Review of Clinical Guidelines for Preconception Care

Author:

Dorney Edwina1ORCID,Boyle Jacqueline A.2,Walker Ruth2ORCID,Hammarberg Karin3ORCID,Musgrave Loretta4ORCID,Schoenaker Danielle56ORCID,Jack Brian6,Black Kirsten I.1

Affiliation:

1. Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia

2. Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia

3. Global and Women's Health, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia

4. School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia

5. School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom

6. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom

Abstract

AbstractPreconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

Publisher

Georg Thieme Verlag KG

Subject

Physiology (medical),Obstetrics and Gynecology,Endocrinology,Reproductive Medicine,Endocrinology, Diabetes and Metabolism

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