[Preconception care: an essential part of the care for mother and child]

Despite the modernisation of antenatal care in the Western world, the incidence of a number of adverse pregnancy outcomes, such as birth defects, low birth weight and preterm birth, has not decreased over the past few decades. Since its inception at the beginning of the last century, the concept of antenatal care has not changed. The first antenatal visit typically starts at the end of the first trimester. By this stage of pregnancy organogenesis and early placentation have been completed making it almost impossible to reverse any unfavourable exposure on the foetus. Preconception care addresses risk factors that are present prior to pregnancy. By either eliminating or altering risk factors during this period, pregnancy outcome may improve. The goal of preconception care is to optimise the quality of foetal, newborn and infant life through primary prevention. With regard to genetic conditions the aims of preconception care are more nuanced. The principle components of preconception care include (a) risk assessment, (b) information and advice on health promotion, (c) specific counselling and (d) intervention. The effectiveness of preconception care has been demonstrated in women who are at increased risk of adverse pregnancy outcome. In women at low-risk, however, the usefulness of preconception care has yet to be established. The concept of preconception care is relatively simple, logical and promises much. For preconception care to be a success, it is crucial to make this form of preventive care available to all prospective parents. The Internet could play a major part in the dissemination of information that is relevant to a successful outcome of pregnancy.