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Preconception indicators and associations with health outcomes reported in UK routine primary care data: a systematic
Danielle Schoenaker1, Elizabeth M Lovegrove2, Emma H Cassinelli3
1School of Human Development and Health, MRC Lifecourse Epidemiology Centre, University of Southampton; National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton.
Insights
Routine primary care data can identify preconception care needs. Linking this data with health outcomes could reduce adverse maternal and child health outcomes.
Area of Science:
- Public Health
- Reproductive Health
- Health Services Research
Background:
- Routine primary care data offers a valuable resource for understanding preconception health.
- It can inform the development and delivery of preconception care services.
Purpose of the Study:
- To review the utility of primary care data for assessing preconception health indicators.
- To examine associations between these indicators and maternal/offspring health outcomes.
Main Methods:
- A systematic review of observational studies utilizing UK routine primary care data.
- Searches identified studies on individuals aged 15-49 years, defining preconception indicators and health outcomes.
Main Results:
- 42 articles were included, detailing 37 preconception indicators in female patients, with high prevalence for advanced maternal age, previous C-section, overweight/obesity, smoking, depression, and anxiety.
- Few studies reported on male patients or outcome associations. Most studies had low risk of bias, but data limitations exist.
Conclusions:
- Routinely collected UK primary care data can identify patient preconception care needs.
- Linking primary care data with other health datasets is underutilized but crucial for quantifying the impact of optimizing preconception care on adverse outcomes.
Background:
Routine primary care data may be a valuable resource for preconception health research and to inform the provision of preconception care.
Aim:
To review how primary care data could provide information on the prevalence of preconception indicators and examine associations with maternal and offspring health outcomes.
Design And Setting:
Systematic review of observational studies using UK routine primary care data.
Method:
Literature searches were conducted in March 2023 using five databases to identify observational studies that used national primary care data from individuals aged 15-49 years. Preconception indicators were defined as medical, behavioural, and social factors that may impact future pregnancies; health outcomes included those that may occur during and after pregnancy.
Results:
From 5259 screened records, 42 articles were included. The prevalence of 37 preconception indicator measures was described for female patients, ranging from 0.01% for sickle cell disease to >20% for each of advanced maternal age, previous caesarean section (among those with a recorded pregnancy), overweight, obesity, smoking, depression, and anxiety (irrespective of pregnancy). Few studies reported indicators for male patients (n = 3) or associations with outcomes (n = 5). Most studies had a low risk of bias, but missing data may limit generalisability of the findings.
Conclusion:
The findings demonstrated that routinely collected UK primary care data could be used to identify patients' preconception care needs. Linking primary care data with health outcomes collected in other datasets is underutilised, but could help to quantify how optimising preconception health and care could reduce adverse outcomes for mothers and children.
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