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  • Title: Preconception health promotion: analysis of means and constraints.
    Author: Delvoye P, Guillaume C, Collard S, Nardella T, Hannecart V, Mauroy MC.
    Journal: Eur J Contracept Reprod Health Care; 2009 Aug; 14(4):307-16. PubMed ID: 19629856.
    Abstract:
    OBJECTIVES: To assess means and constraints of preconception care implementation. METHODS: Three strategies were applied to promote preconception health: organisation of a campaign, production of guidelines, and implementation of a preconception pilot clinic. Three surveys investigated the knowledge and practices of women before and after the campaign, and one survey assessed the attitudes of gynaecologists. RESULTS: Posters and leaflets are more efficient than TV spots; implementation of a pilot clinic enhances all activities in the field of preconception health. With regard to constraints, we observed that (i) preconception care could not be provided when pregnancy was unplanned; (ii) the necessity of postponing pregnancy interfered with vaccinations; (iii) the compliance of women with regard to the prolonged intake of folates is poor; (iv) the application of guidelines by providers is inconsistent; (v) providers lack training regarding genetic ethical stakes; and (vi) practitioners find it difficult to integrate the concept of private eugenics and to envision the probabilistic character of the clinical manifestations of inherited diseases. CONCLUSIONS AND RECOMMENDATIONS: We propose (i) flour fortification with folic acid; (ii) timely immunisation by preventive medicine at school, and (iii) continuous training of health care providers in the provision of preconception care.
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