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Do we practice what we preach? A review of actual clinical practice with regards to preconception care guidelines
Michele Curtis1, Steve Abelman, Jay Schulkin
1University of Texas-Houston, Houston, TX, USA.
Insights
Preconception care varies widely due to a lack of national guidelines. Understanding current practices is crucial for developing standardized recommendations to improve women
Area of Science:
- Reproductive Health
- Public Health Policy
- Clinical Practice Guidelines
Background:
- Existing clinical practices for preconception care lack uniformity.
- There are no comprehensive national recommendations for preconception care.
- Variability in current clinical approaches necessitates a review of existing practices.
Purpose of the Study:
- To review existing studies on clinical practices and approaches to preconception care.
- To understand the current landscape of preconception care delivery.
- To inform the development of national guidelines for preconception care.
Main Methods:
- A comprehensive literature review was conducted using Medline.
- The review covered studies published between 1966 and September 2005.
- Keywords included "preconception care," "practice patterns," and "pregnancy outcomes."
Main Results:
- Significant variability exists in the clinical provision of preconception care.
- No current national recommendations fully address preconception care.
- The lack of standardization impacts the quality and consistency of care provided.
Conclusions:
- Efforts are underway to develop uniform national recommendations for preconception care.
- Understanding current practice patterns and barriers is vital for guideline development.
- Successful implementation of guidelines is essential for influencing women's health policy.
Objectives:
To review what past studies have found with regard to existing clinical practices and approaches to providing preconception care.
Methods:
A literature review between 1966 and September 2005 was performed using Medline. Key words included preconception care, preconception counseling, preconception surveys, practice patterns, pregnancy outcomes, prepregnancy planning, and prepregnancy surveys.
Results:
There are no current national recommendations that fully address preconception care; as a result, there is wide variability in what is provided clinically under the rubric of preconception care.
Conclusions:
In 2005, the Centers for Disease Control and Prevention sponsored a national summit regarding preconception care and efforts are underway to develop a uniform set of national recommendations and guidelines for preconception care. Understanding how preconception care is presently incorporated and manifested in current medical practices should help in the development of these national guidelines. Knowing where, how, and why some specific preconception recommendations have been successfully adopted and translated into clinical practice, as well as barriers to implementation of other recommendations or guidelines, is vitally important in developing an overarching set of national guidelines. Ultimately, the success of these recommendations rests on their ability to influence and shape women's health policy.
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