The prevalence and nature of the use of preconception services by women with chronic health conditions: an integrative review

Steel, Amie; Lucke, Jayne; Adams, Jon

doi:10.1186/s12905-015-0165-6

Cited by 53 publications

(42 citation statements)

References 71 publications

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“…Some very common examples of these conditions include pre‐existing diabetes, chronic hypertension, sickle cell disease, cardiomyopathy, and HIV infection. Yet, an integrative review on the prevalence of the use of prepregnancy services by women with chronic health conditions reported estimates of engagement with prepregnancy care ranging between 18.1% and 45%, with most studies focusing on women with types 1 and 2 diabetes . These estimates are likely to be lower in resource‐constrained settings, where such services may not be available.…”

Section: Approaches To Delivering Maternal Health Servicesmentioning

confidence: 99%

A framework for healthcare interventions to address maternal morbidity

Firoz

McCaw-Binns

Filippi

et al. 2018

Int J Gynecol Obstet

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The maternal health agenda is undergoing a paradigm shift from preventing maternal deaths to promoting women's health and wellness. A critical focus of this trajectory includes addressing maternal morbidity and the increasing burden of chronic and noncommunicable diseases (NCD) among pregnant women. The WHO convened the Maternal Morbidity Working Group (MMWG) to improve the scientific basis for defining, measuring, and monitoring maternal morbidity. Based on the MMWG's work, we propose paradigms for conceptualizing maternal health and related interventions, and call for greater integration between maternal health and NCD programs. This integration can be synergistic, given the links between chronic conditions, morbidity in pregnancy, and long‐term health. Pregnancy should be viewed as a window of opportunity into the current and future health of women, and offers critical entry points for women who may otherwise not seek or have access to care for chronic conditions. Maternal health services should move beyond the focus on emergency obstetric care, to a broader approach that encompasses preventive and early interventions, and integration with existing services. Health systems need to respond by prioritizing funding for developing integrated health programs, and workforce strengthening. The MMWG's efforts have highlighted the changing landscape of maternal health, and the need to expand the narrow focus of maternal health, moving beyond surviving to thriving.

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Section: Approaches To Delivering Maternal Health Servicesmentioning

confidence: 99%

A framework for healthcare interventions to address maternal morbidity

Firoz

McCaw-Binns

Filippi

et al. 2018

Int J Gynecol Obstet

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show abstract

“…The scoping review identified only one behavioral intervention directly supporting women in the preconception period who were planning a pregnancy. While the opportunity to support women at the individual level who are actively planning a pregnancy is important, it is also limited by low preconception care engagement (60-80% of women don't receive preconception care [133][134][135]) and unplanned pregnancies, with global estimates that 44% of all pregnancies are unintended [136].…”

Section: Discussionmentioning

confidence: 99%

Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions

et al. 2020

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Background: Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. Methods: Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15-44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes.Results: Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). Conclusions: This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.

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“…Long‐term follow‐up is thus beneficial in understanding the effects of nutritional interventions in the first 1000 days on the incidence NCDs. In addition, process evaluations of preconception interventions have shown that the prevalence estimate for engagement with preconception services ranged between 18.1% and 45% depending upon the chronic health condition examined …”

Section: Discussionmentioning

confidence: 99%

Narrative review of reviews of preconception interventions to prevent an increased risk of obesity and non‐communicable diseases in children

2019

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Evidence for the effect of preconception and periconceptional risk factors on childhood outcomes such as obesity and other non-communicable diseases (NCDs) in later life is growing. Issues such as maternal malnutrition need to be addressed before pregnancy, to prevent a transgenerational passage of risk of NCDs. The aim of this review was to evidence for preconception interventions to prevent obesity and other risk factors for NCDs in children. A search for systematic reviews of interventions in the preconception period published between 2006 and 2018 was conducted on academic databases. Fifteen reviews were included, two of the reviews also included pregnant women. None of the reviews directly reported on obesity or NCD outcomes in children. Results suggest that exercise-and diet-based interventions significantly reduced maternal weight postpartum, weight gain during pregnancy, and improved prevention and control of gestational diabetes. Balanced protein energy supplementation during and before pregnancy was associated with an increase in mean birth weight and reduction of low birth weight babies. There is a dearth of evidence for preconception programmes that follow up on childhood outcomes related to a risk of NCDs. Nevertheless, results suggest that women who received preconception interventions were more likely to have improved pregnancy-related and behavioural outcomes.

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The prevalence and nature of the use of preconception services by women with chronic health conditions: an integrative review

Cited by 53 publications

References 71 publications

A framework for healthcare interventions to address maternal morbidity

A framework for healthcare interventions to address maternal morbidity

Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions

Narrative review of reviews of preconception interventions to prevent an increased risk of obesity and non‐communicable diseases in children

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