Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/97533
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Type: Journal article
Title: Preconception care: screening and management of chronic disease and promoting psychological health
Author: Lassi, Z.
Imam, A.
Dean, S.
Bhutta, Z.
Citation: Reproductive Health, 2014; 11(Suppl. 3):S5-1-S5-20
Publisher: BioMed Central
Issue Date: 2014
ISSN: 1742-4755
1742-4755
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Responsibility: 
Zohra S Lassi, Ayesha M Imam, Sohni V Dean, Zulfiqar A Bhutta
Abstract: INTRODUCTION: A large proportion of women around the world suffer from chronic diseases including mental health diseases. In the United States alone, over 12% of women of reproductive age suffer from a chronic medical condition, especially diabetes and hypertension. Chronic diseases significantly increase the odds for poor maternal and newborn outcomes in pregnant women. METHODS: A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for preventing and managing chronic diseases and promoting psychological health on maternal, newborn and child health outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. RESULTS: Maternal prepregnancy diabetic care is a significant intervention that reduces the occurrence of congenital malformations by 70% (95% Confidence Interval (CI): 59-78%) and perinatal mortality by 69% (95% CI: 47-81%). Furthermore, preconception management of epilepsy and phenylketonuria are essential and can optimize maternal, fetal and neonatal outcomes if given before conception. Ideally changes in antiepileptic drug therapy should be made at least 6 months before planned conception. Interventions specifically targeting women of reproductive age suffering from a psychiatric condition show that group-counseling and interventions leading to empowerment of women have reported non-significant reduction in depression (economic skill building: Mean Difference (MD) -7.53; 95% CI: -17.24, 2.18; counseling: MD-2.92; 95% CI: -13.17, 7.33). CONCLUSION: While prevention and management of the chronic diseases like diabetes and hypertension, through counseling, and other dietary and pharmacological intervention, is important, delivering solutions to prevent and respond to women's psychological health problems are urgently needed to combat this leading cause of morbidity.
Keywords: Humans; Pregnancy Complications; Chronic Disease; Mass Screening; Pregnancy Outcome; Preconception Care; Mental Disorders; Pregnancy; Health Promotion; Female
Rights: © 2014 Lassi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
RMID: 0030038036
DOI: 10.1186/1742-4755-11-S3-S5
Appears in Collections:Medicine publications

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