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Ten years of experience in periconceptional care
1Department of Human Genetics and Teratology, National Institute of Public Health/WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary.
Insights
Periconceptional care, including counselling and medical intervention, significantly reduces major congenital abnormalities by promoting folic acid use and reducing smoking/alcohol consumption. This comprehensive approach to reproductive health is feasible and beneficial for expectant parents.
Area of Science:
- Reproductive Health
- Maternal and Child Health
- Public Health Interventions
Background:
- Periconceptional care encompasses counselling, examinations, and medical interventions aimed at optimizing reproductive health before and during early pregnancy.
- The term 'periconceptional' includes the early postconceptional period, crucial for embryonic development.
- This service in Hungary was developed to provide structured preparation for conception and early pregnancy support.
Purpose of the Study:
- To describe the methodologies employed in periconceptional care services in Hungary.
- To evaluate the effectiveness of a structured periconceptional care model.
- To assess the impact of periconceptional care on health promotion and congenital abnormality prevention.
Main Methods:
- A three-step model was implemented: reproductive health check-up, a 3-month preparation for conception, and early pregnancy protection.
- Data from 8837 female and 7600 male participants in Hungarian periconceptional care programs (1984-1994) were analyzed.
- Participant characteristics included mean maternal age (25.8 years), primiparity (84%), and high education (60%).
Main Results:
- Periconceptional care, supervised by nurses, effectively identified and managed participants with risk factors (family/case history, infections) and infertility.
- The program successfully promoted folic acid/multivitamin supplementation and reduced smoking and alcohol consumption among females.
- A significant reduction in major congenital abnormalities was observed (20.6/1000) compared to the expected rate (35/1000).
Conclusions:
- Periconceptional care is a feasible and highly beneficial intervention.
- Optimal preparation for conception represents a critical early health promotion strategy.
- This approach is particularly effective in preventing congenital abnormalities.
Objectives:
To describe the methods of the periconceptional care, consisting of counselling, examinations and medical intervention in Hungary. The term periconceptional is used instead of preconceptional because early postconceptional period is also involved to this service.
Methods:
A model was developed based on three steps: check-up of reproductive health (i.e. preconceptional screening), the 3-month preparation for conception, and better protection in early pregnancy for the most sensitive early development of embryo for voluntary and eligible couples. Data of 8837 female and 7600 male participants from the coordinating centre of the Hungarian periconceptional care between 1 February 1984 and 31 January 1994 are summarized. Mean maternal age was 25.8+/-3.4 years, 84 and 60% of female participants were primiparae, and had high education (> or = 13 classes), respectively.
Results:
It was possible to establish periconceptional care performed and/or supervised by qualified nurses. Participants with positive family history, case history and where genitourinary infections were detected, had a more effective flow towards secondary care. Infertile couples were diagnosed and treated sooner. The periconceptional care is effective for the introduction of periconceptional folic acid/multivitamin supplementation and for the reduction of smoking and alcohol consumption in females in the preconceptional period. The rate of major congenital abnormalities (20.6/1000) was significantly lower than expected (35/1000).
Conclusions:
Periconceptional care is feasible and has many benefits. Thus, proper preparation for conception is the earliest and probably the most important method of health promotion in general, particularly for the prevention of congenital abnormalities.