Abstract
BackgroundThere is growing evidence that preconception care may have an important role in preventing short and long term adverse health consequences for women and their offspring. This is particularly the case for women with chronic health conditions due to the rising prevalence of chronic disease in global populations. With this in mind, this paper presents an integrative systematic review of contemporary research outlining the use of preconception services and practices by women with chronic health conditions.MethodsA search was conducted through PubMed, CINAHL, AMED, and Maternity and Infant Care databases which identified 672 papers examining preconception care and preconception services for women with chronic health conditions. Fourteen papers which were written in English, presented original research, and reported on the prevalence or nature of use of preconception care by women with chronic health conditions were included in the review. Critical appraisal of study quality and thematic categorical grouping of identified papers was undertaken.ResultsCurrent research evidence, as identified through this review, examines three major topic areas: the prevalence of preconception care practices, use of services and characteristics of users; knowledge of the value and impact of preconception care and availability of preconception services for women with chronic health conditions; and women’s attitudes, approaches and experiences of preconception care and preconception services. Prevalence estimates of engagement with preconception care range between 18.1% and 45%, with most studies focusing on women with type 1 or 2 diabetes. Significant gaps in women’s knowledge of preconception care for women with chronic health conditions were also identified. Women with chronic health conditions reported experiencing emotional distress as a result of their engagement with preconception care services. They also commonly described feeling a need to employ discipline to comply with preconception care programs, and experiencing a fear of pregnancy complications.ConclusionFuture research requires a broad and sophisticated approach to research design and analysis, improved consideration of temporal changes to women’s health behaviour, representative samples to more effectively inform health policy, and a deeper understanding of women’s motivations, attitudes and perceptions of preconception care to assist in the development of tailored preconception health services.
Highlights
There is growing evidence that preconception care may have an important role in preventing short and long term adverse health consequences for women and their offspring
This paper provides a review of international contemporary literature with a specific focus upon the prevalence and nature of use of preconception care practices and services by women with chronic health conditions
This review provides an examination of the prevalence and nature of the use of preconception care services by women with chronic health conditions worldwide
Summary
There is growing evidence that preconception care may have an important role in preventing short and long term adverse health consequences for women and their offspring. This is the case for women with chronic health conditions due to the rising prevalence of chronic disease in global populations. Impact of preconception health status on outcomes for women and neonates Preconception care has received increased attention due to growing evidence that maternal health prior to conception can directly affect the health of the mother and the fetal environment during pregnancy [2]. Maternal health behaviours which have been clearly identified as important in the context of preconception care include diet [19], smoking [20], alcohol consumption [21] and exposure to communicable diseases [22]
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