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Addressing preconception risks identified at the time of a negative pregnancy test. A randomized trial
B W Jack1, L Culpepper, J Babcock
1Department of Family Medicine, Boston University School of Medicine, MA 02118, USA. brian.jack@bmc.org
The Journal of Family Practice
|July 23, 1998
Summary
Identifying preconception risks in women did not improve intervention rates. A structured system with office-based protocols is necessary for effective preconception care and risk reduction.
Area of Science:
- Reproductive Health
- Preventive Medicine
- Clinical Trial Research
Background:
- Preconception care programs aim to guide women toward healthy pregnancies by identifying risks and assessing readiness.
- A randomized controlled trial was performed to evaluate the effectiveness of preconception risk assessment and referral to primary care.
Purpose of the Study:
- To determine if comprehensive preconception risk assessment and subsequent referral to primary care services effectively initiate treatment for identified risks.
- To assess the impact of informing women and their clinicians about identified preconception risks on intervention rates.
Main Methods:
- 170 women were randomized into usual care or intervention groups after a negative pregnancy test and risk assessment.
- The intervention group received information on risks and a primary care appointment; clinicians were also informed.
- Follow-up involved chart reviews and phone calls to ascertain if interventions were offered within one year.
Main Results:
- An average of 8.96 risks were identified per woman, with prevalence ranging from 19% to 71% across 12 categories.
- 59% of women attended at least one visit, with risk intervention rates varying from 18% (psychosocial) to 48% (fetal exposures).
- No significant difference in the percentage of risks addressed was observed between the intervention and usual care groups.
Conclusions:
- Informing women and clinicians about identified preconception risks did not enhance intervention rates.
- A more organized intervention system, incorporating office-based protocols, is required for successful preconception risk management.
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