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Optimize maternal and infant health with prepregnancy care. Key interventions include folic acid, substance cessation, immunizations, and screenings to reduce risks and improve outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Public Health
  • Preventive Medicine

Background:

  • 66.4% of US reproductive-aged women have modifiable risk factors for adverse pregnancy outcomes.
  • Prepregnancy care is crucial for optimizing maternal and infant health.
  • Unintended pregnancies are linked to higher risks of postpartum depression, preterm birth, and low infant birth weight.

Purpose of the Study:

  • To highlight the importance of prepregnancy care and counseling.
  • To outline key interventions for individuals desiring pregnancy.
  • To emphasize the role of primary care in optimizing pregnancy outcomes.

Main Methods:

  • Review of interventions including folic acid supplementation, cessation of tobacco, alcohol, cannabis, and opioids.
  • Discussion of immunizations against hepatitis B virus, varicella, and rubella.
  • Emphasis on screening for syphilis and HIV, chronic disease management, and weight management.

Main Results:

  • Folic acid use reduces fetal neural tube defects (RR, 0.67).
  • Tobacco smoking increases risks of stillbirth, neonatal, and perinatal death.
  • Prepregnancy interventions decrease fetal and neonatal infection and mortality.
  • Optimizing chronic conditions like diabetes and cardiovascular disease before conception reduces risks.

Conclusions:

  • Prepregnancy counseling and care significantly reduce maternal and neonatal morbidity and mortality.
  • Primary care plays a vital role in discussing reproductive goals, immunizations, screenings, and risk-reducing interventions.
  • Proactive health management before conception is essential for positive pregnancy outcomes.