The effect of a preconception care outreach strategy: the Healthy Pregnancy 4 All study

Meertien K Sijpkens,Ageeth N Rosman,Lieke C De Jong-Potjer,Arnoud P Verhoeff,Loes C M Bertens,Semiha Denktaş,Eric A P Steegers,Sabine F Van Voorst

doi:10.1186/s12913-019-3882-y

Abstract

BackgroundPreconception care has been acknowledged as an intervention to reduce perinatal mortality and morbidity. However, utilization of preconception care is low because of low awareness of availability and benefits of the service. An outreach strategy was employed to promote uptake of preconception care consultations. Its effect on the uptake of preconception care consultations was evaluated within the Healthy Pregnancy 4 All study.MethodsWe conducted a community-based intervention study. The outreach strategy for preconception care consultations included four approaches: (1) letters from municipal health services; (2) letters from general practitioners; (3) information leaflets by preventive child healthcare services and (4) encouragement by peer health educators. The target population was set as women aged 18 to 41 years in 14 Dutch municipalities with relatively high perinatal morbidity and mortality rates. We evaluated the effect of the outreach strategy by analyzing uptake of preconception care consultations between February 2013 and December 2014. Registration data of applications for preconception care as well as participant questionnaires were obtained for analysis.ResultsThe outreach strategy led to 587 applications for preconception care consultations. The majority of applications (n = 424; 72%) were prompted by the invitation letters (132,129) from the municipalities and general practitioners. The effect of the municipal letter seemed to fade out after 3 months.ConclusionsOutreach strategies amongst the general population promote uptake of preconception care consultations, although on a small scale and with a temporary effect.

Highlights

Preconception care has been acknowledged as an intervention to reduce perinatal mortality and morbidity
Recognition that Dutch perinatal mortality rates are higher than rates in other comparable European countries has placed Preconception care (PCC) both on the political and professional agenda [4, 5]
The potential outreach in all municipalities together was set as the total number of women aged 18– 41 years residing in these areas, which consisted of 165,615 women

Summary

Introduction

Preconception care has been acknowledged as an intervention to reduce perinatal mortality and morbidity. Preconception care (PCC) has been advocated to identify and modify relevant risks (e.g. biomedical, behavioral, and social risks) to a woman’s health and pregnancy outcome before conception [1, 3]. Recognition that Dutch perinatal mortality rates are higher than rates in other comparable European countries has placed PCC both on the political and professional agenda [4, 5]. This has resulted in governmental advisory reports, guidelines and tools for professionals [6, 7]. An important challenging factor seems to be low awareness about preconception health and PCC among women [12, 13]. We could reach the majority of the target population, since most pregnancies in the Netherlands are planned

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