Preconception Care

  • Brian W. Jack
  • Larry Culpepper


Family physicians have practiced risk reduction in preparation for pregnancy for many years as part of such activities as premarital counseling, family planning, and genetic counseling. In recent years the idea has emerged of an organized program that identifies and reduces reproductive risks before conception and prepares both parents and the family for pregnancy and child-bearing. This concept has been called preconception care.1


Human Immunodeficiency Virus Genetic Counseling Prenatal Care Family Physician Spina Bifida 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    US Public Health Service Expert Panel on the Content of Prenatal Care. Caring for our future: the content of prenatal care. Washington, DC: Department of Health and Human Services, 1989.Google Scholar
  2. 2.
    Jack B, Culpepper L. Preconception care: risk reduction and health promotion in preparation for pregnancy. JAMA 1990;264:1147–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Jack B, Culpepper L. Preconception care. In: Merkatz IR, Thompson JE, Mullen PD, Goldenberg RL, editors. New perspectives on prenatal care. New York: Elsevier, 1990:69–88.Google Scholar
  4. 4.
    Office of the Surgeon General. Healthy people 2000: national health promotion and disease prevention objectives. Washington, DC: Public Health Service, Department of Health and Human Services, 1990.Google Scholar
  5. 5.
    Jack BW, Culpepper L. Preconception care. J Fam Pract 1991; 32: 306–15.PubMedGoogle Scholar
  6. 6.
    Gjerdingen DK, Fontaine P. Preconception health care: a critical task for family physicians. J Am Board Fam Pract 1991;4:237–50.PubMedGoogle Scholar
  7. 7.
    European Collaborative Study. Risk factors for mother-to-child transmission of HIV-1. Lancet 1992;339:1007–12.CrossRefGoogle Scholar
  8. 8.
    Centers for Disease Control, Immunization Practices Advisory Committee. Prevention of perinatal transmission of hepatitis B virus: prenatal screening of all pregnant women for hepatitis B surface antigen. MMWR 1988;37:341–6.Google Scholar
  9. 9.
    Stevens CE, Toy PT, Tong MJ, et al. Perinatal hepatitis B virus transmission in the United States: prevention by passive-active immunization. JAMA 1985;253:1740–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Centers for Disease Control. Changing patterns of groups at high risk for hepatitis B in the United States. MMWR 1988;37:429–32.Google Scholar
  11. 11.
    Wilson CB, Remington JS. What can be done to prevent congenital toxoplasmosis? Am J Obstet Gynecol 1980;138:357–63.PubMedGoogle Scholar
  12. 12.
    Krick JA, Remington JS. Toxoplasmosis in the adult—an overview. N Engl J Med 1978;298:550–3.PubMedCrossRefGoogle Scholar
  13. 13.
    Fuccillo DA, Madden DL, Tzan NR, et al. Difficulties associated with serological diagnosis of Toxoplasma gondii infections. Diagn Clin Immunol 1987;5:8–13.PubMedGoogle Scholar
  14. 14.
    Centers for Disease Control. Rubella and congenital rubella syndrome—United States, 1985–1988. MMWR 1989;38:172–88.Google Scholar
  15. 15.
    Centers for Disease Control. Rubella vaccination during pregnancy—United States, 1971–1988. MMWR 1989;38:289–93.Google Scholar
  16. 16.
    Paryani SG, Avrin AM. Intrauterine infections with varicella-zoster virus after maternal varicella. N Engl J Med 1986;34:1542.CrossRefGoogle Scholar
  17. 17.
    Culpepper L, Thompson JE. Work during pregnancy. In: Merkatz IR, Thompson JE, Mullen PD, Goldenberg, R, editors. New perspectives on prenatal care. New York: Elsevier, 1990:211–34.Google Scholar
  18. 18.
    Doering P, Stewart R. The extent and character of drug consumption during pregnancy. JAMA 1978;239:243–6.CrossRefGoogle Scholar
  19. 19.
    Barrett JM, Van Hooydonk JE, Boehm FH. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv 1982;37:557–66.PubMedCrossRefGoogle Scholar
  20. 20.
    Drogari E, Smith I, Beasley M, Lloyd JK. Timing of strict diet in relation to fetal damage in maternal phenylketonuria. Lancet 1987; 2:927–30.PubMedCrossRefGoogle Scholar
  21. 21.
    Piatt LD, Koch R, Azen C, et al. Maternal phenylketonuria collaborative study, obstetric aspects and outcome: the first 6 years. Am J Obstet Gynecol 1992;166:1150–62.CrossRefGoogle Scholar
  22. 22.
    Steel JM, Johnston FD. Prepregnancy management of the diabetic. In: Chamberlain G, Lumley J, editors. Prepregnancy care: a manual for practice. Chichester: J Wiley, 1986:165–82.Google Scholar
  23. 23.
    Rowe BR, Rowbotham CJF, Barnett AH. Preconception counseling, birthweight, and congenital abnomalities in established and gestational diabetic pregnancy. Diabetes Res 1987;6:33–35.PubMedGoogle Scholar
  24. 24.
    Fuhrmann K, Reiher H, Semmter K, Glockner E. The effect of intensified nutritional therapy before and during pregnancy on the malformation rate in offspring of diabetic women. Exp Clin Endocrinol 1984;83:173–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Mills JL, Knopp RH, Simpson JL, et al. Lack of relation of increased malformation rates in infants of diabetic mothers to glycémie control during organogenesis. N Engl J Med 1988;31:671–6.CrossRefGoogle Scholar
  26. 26.
    Taysi K. Preconceptional counseling. Obstet Gynecol Clin North Am 1988;15:167–78.PubMedGoogle Scholar
  27. 27.
    Delgado-Escueta AV, Janz D. Consensus guidelines: preconception counseling, management, and care of the pregnant women with epilepsy. Neurology 1992;42:149–60.PubMedCrossRefGoogle Scholar
  28. 28.
    Momotani N, Noh J, Oyanagi H, Ishikawa N, Ito K. Antithyroid drug therapy of Graves’ disease during pregnancy: optimal regimen for fetal thyroid status. N Engl J Med 1986;315:24–28.PubMedCrossRefGoogle Scholar
  29. 29.
    Man EB, Brown JF, Surunaian SA. Matemal hypothyroxinemia: psychoneurological deficits of progeny. Ann Clin Lab Sei 1991;21: 227–39.Google Scholar
  30. 30.
    Lockshin MD, Druzin ML, Goei S, et al. Antibody to cardiolipin as a predictor of fetal distress or death in pregnant patients with systemic lupus erythematosus. N Engl J Med 1985;313:152–6.PubMedCrossRefGoogle Scholar
  31. 31.
    Lubbe WF, Butler WS, Palmer SJ, Liggins GC. Fetal survival after prednisone suppression of maternal lupus-anticoagulant. Lancet 1983;1:1361–3.PubMedCrossRefGoogle Scholar
  32. 32.
    Antenatal diagnosis of genetic disorders. Technical bulletin no. 108. Washington, DC: American College of Obstetricians and Gynecologists, 1987.Google Scholar
  33. 33.
    Lemna WK, Feldman GL, Kerem B-S, et al. Mutation analysis for heterozygote detection and the prenatal diagnosis of cystic fibrosis. N Engl J Med 1990;322:291–6.PubMedCrossRefGoogle Scholar
  34. 34.
    Naeye RL. Weight gain and the outcomes of pregnancy. Am J Obstet Gynecol 1979;135:3–9.PubMedGoogle Scholar
  35. 35.
    Johnson SR, Kolberg BH, Varner MWS, Railsback LD. Maternal obesity and pregnancy. Surg Gynecol Obstet 1987;164:431–7.PubMedGoogle Scholar
  36. 36.
    MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council vitamin study. Lancet 1991;338:131–7.CrossRefGoogle Scholar
  37. 37.
    Use of folic acid for prevention of spina bifida and other neural tube defects 1982–1991. MMWR 1991;40:513–6.Google Scholar
  38. 38.
    Czeizel AE, Dudas I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327:1832–5.PubMedCrossRefGoogle Scholar
  39. 39.
    Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR 1992;41:1–7.Google Scholar
  40. 40.
    Olds DL, Henderson CR, Tatelbaum R, Chamberlin R. Improving the delivery of prenatal care and outcomes of pregnancy: a randomized trial of nurse home visitation. Pediatrics 1986;77:16–28.PubMedGoogle Scholar
  41. 41.
    Thompson JE. Maternal stress, anxiety, and social support during pregnancy: possible direction for prenatal intervention. In: Merkatz IR, Thompson JE, Mullen PD, Goldenberg R, editors. New perspectives on prenatal care. New York: Elsevier, 1990: 319–35.Google Scholar
  42. 41.
    Thompson JE. Maternal stress, anxiety, and social support during pregnancy: possible direction for prenatal intervention. In: Merkatz IR, Thompson JE, Mullen PD, Goldenberg R, editors. New perspectives on prenatal care. New York: Elsevier, 1990: 319–35.Google Scholar
  43. 42.
    Ramsey CN, Abell TD, Baker LC. The relationship between family functioning, life events, family structure and the outcome of pregnancy. J Fam Pract 1986;22:521–7.PubMedGoogle Scholar
  44. 43.
    Oster G, Delea TE, Colditz GA. Maternal smoking during pregnancy and expenditures on neonatal health care. Am J Prev Med 1988;4:21609.Google Scholar
  45. 44.
    Williamson DF, Serdula MK, Kendrick JS, Binkin MJ. Comparing the prevalence of smoking in pregnant and nonpregnant women, 1985 to 1986. JAMA 1989;261:70–74.PubMedCrossRefGoogle Scholar
  46. 45.
    Fox SH, Brown C, Koontz AM, Kesseil SS. Perceptions of risks of smoking and heavy drinking during pregnancy: 1985 NHIS findings. Public Health Rep 1987;102:73–79.PubMedGoogle Scholar
  47. 46.
    Waren KR, Bast RJ. Alcohol-related birth defects: an update. Public Health Rep 1988;103:638–42.Google Scholar
  48. 47.
    Hanson JW, Streissguth AP, Smith DW. The effects of moderate alcohol consumption during pregnancy on fetal growth and morphogenesis. J Pediatr 1978;92:457–60.PubMedCrossRefGoogle Scholar
  49. 48.
    Hadeed AJ, Siegel SR. Maternal cocaine use during pregnancy: effect on the newborn infant. Pediatrics 1989;84:205–10.PubMedGoogle Scholar
  50. 49.
    MacGregor SN, Keith LG, Chasnoff IJ, et al. Cocaine use during pregnancy: adverse perinatal outcome. Am J Obstet Gynecol 1987; 157:686–90.PubMedGoogle Scholar
  51. 50.
    National Association for Perinatal Addiction Research and Education. Innocent addicts: high rate of prenatal drug abuse found. ADAMHANews. Rockville, MD: National Institute on Drug Abuse, October 1988.Google Scholar
  52. 51.
    Chasnoff IJ. Cocaine: effects on pregnancy and the neonate. In: Drugs, alcohol, pregnancy and parenting. Dordrecht, The Netherlands: Kluwer, 1988:97–103.CrossRefGoogle Scholar
  53. 52.
    Whitley RJ, Goldenberg RL. Infectious disease in the prenatal period and recommendations for screening In: Merkatz IR, Thompson JE, Mullen PD, Goldenberg RL, editors. New perspective on prenatal care. New York: Elsevier, 1990:363–406.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Brian W. Jack
  • Larry Culpepper

There are no affiliations available

Personalised recommendations