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National and international guidelines for preconception care and comparison with Australian guidelines: a systematic
Alemayehu Mekonnen1, Jenny Doust1, Dereje Gete1
1Australian Women and Girls' Health Research Centre, School of Public Health, Faculty of Health, Medicine and Behavioural Science, The University of Queensland, Brisbane, Qld 4006, Australia.
Insights
The Royal Australian College of General Practitioners (RACGP) Red Book guidelines for preconception care lack key evidence-based elements. Enhancing these guidelines could improve Australian women's reproductive health.
Area of Science:
- Public Health
- Preventive Medicine
- Women's Health
Background:
- Preconception care guidelines are crucial for consistent, high-quality healthcare.
- The RACGP Red Book offers some preconception care components but may not be comprehensive.
- Recent evidence suggests a need to update existing guidelines.
Purpose of the Study:
- To compare the 2024 RACGP Red Book with national and international preconception care guidelines.
- To identify evidence-based preconception care elements missing from current RACGP guidelines.
- To inform the development of improved preconception care tools for Australian general practice.
Main Methods:
- Systematic literature search of electronic databases (PubMed, Embase, Web of Science, CINAHL, Scopus) following PRISMA guidelines.
- Inclusion of clinical guideline registries from professional organizations.
- Searches conducted between May-June 2024 and July 2025.
Main Results:
- Seven additional national and international preconception care guidelines were identified.
- Key missing elements in RACGP guidelines include male partner involvement, domestic violence screening, chlamydia/gonorrhea screening, and female genital mutilation screening.
- Four elements were identified to potentially enhance preconception care implementation in Australia.
Conclusions:
- The current RACGP Red Book requires updates to incorporate essential, evidence-based preconception care elements.
- Integrating male partners and specific screenings can significantly improve preconception health outcomes.
- This review supports the development of a comprehensive preconception medical record tool for general practice.
Background:
Guidelines for preconception care are resources that are systematically arranged based on evidence and local contexts to enhance the delivery of high-quality and consistent healthcare. The Royal Australian College of General Practitioners Guidelines (RACGP) for preventive activities in general practice (the Red Book) contains specific components of preconception care items, yet this guideline primarily focuses on general preventive healthcare and may not include a comprehensive list of preconception items based on more recent evidence. This review aimed to compare the recent RACGP guidelines (the 2024 Red Book) with national and international guidelines for preconception care.
Methods:
Electronic databases, including PubMed, Embase, Web of Science, CINAHL, and Scopus, were systematically searched following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We also searched clinical guideline registries on professional organisations' websites. Searches were conducted from May to June 2024 and in July 2025.
Results:
We identified seven other national and international guidelines that recommended what should be done as part of preconception health in clinical practice. Preconception care elements that were not included in the current RACGP guidelines that have evidence of effectiveness were the inclusion of men in preconception care, screening for intimate partners and domestic violence, screening for chlamydia and gonorrhoea infections, and screening for female genital mutilation as part of preconception care.
Conclusions:
This review identified four preconception care elements that may potentially improve the implementation of preconception care in Australian practice. This work informs the next steps towards developing a comprehensive preconception medical record tool for use in general practice.
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