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Semin Reprod Med 2022; 40(03/04): 157-169
DOI: 10.1055/s-0042-1748190
Review Article

A Systematic Review of Clinical Guidelines for Preconception Care

Edwina Dorney 
1   Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
,
Jacqueline A. Boyle
2   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
,
Ruth Walker 
2   Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
,
Karin Hammarberg 
3   Global and Women's Health, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia
,
Loretta Musgrave 
4   School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
,
Danielle Schoenaker 
5   School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
6   NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
,
Brian Jack
6   NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
,
Kirsten I. Black
1   Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Abstract

Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

Keywords

preconception - pre-pregnancy - clinical practice guideline - policy - systematic review

Authors' Contribution

The authors certify that:

All information is truthful and as complete as possible.

All authors have participated in planning of the project.

All authors have been responsible for the writing of the manuscript.

Research was conducted in accordance with the ethical and research arrangements of the organizational institutions involved.


Supplementary Material



Publication History

Article published online:
16 May 2022

© 2022. Thieme. All rights reserved.

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