Pre-conception care: an important yet underutilised preventive care strategy

Deborah J Bateson and Kirsten I Black
Med J Aust 2018; 209 (9): . || doi: 10.5694/mja18.00769
Published online: 5 November 2018

Parental health prior to conception is increasingly recognised as being important for the health of future generations

Pre-conception care is the provision of health recommendations to women of reproductive age with the goal of improving short and long term health outcomes for both the mothers and their children. It includes an assessment of medical conditions, vaccination status, and lifestyle factors.1 While pre-conception care will benefit any woman contemplating pregnancy, it is particularly important for women with medical conditions such as diabetes and obesity. Nevertheless, it is often underutilised.2 In this article, we describe strategies for overcoming challenges to providing pre-conception care and provide guidance for time-poor clinicians.

  • 1 Family Planning New South Wales, Sydney, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 Royal Prince Alfred Hospital, Sydney, NSW


Competing interests:

No relevant disclosures.

  • 1. Royal Australian College of General Practitioners. Preventive activities prior to pregnancy. In: Guidelines for preventive activities in general practice. 9th edition. Melbourne: RACGP, 2017. (viewed Sept 2018).
  • 2. McElduff A, Ross GP, Lagstrom JA, et al. Pregestational diabetes and pregnancy: an Australian experience. Diabetes Care 2005; 28: 1260-1261.
  • 3. Rassi A, Wattimena J, Black K. Pregnancy intention in an urban Australian antenatal population. Aust N Z J Public Health 2013; 37: 568-573.
  • 4. Mazza D, Chapman A, Michie S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Serv Res 2013; 13: 36.
  • 5. Bellanca HK, Hunter MS. ONE KEY QUESTION: preventive reproductive health is part of high quality primary care. Contraception 2013; 88: 3-6.
  • 6. Tommy’s. Planning for pregnancy [website]. 2018. (viewed Sept 2018).
  • 7. De-Regil LM, Peña-Rosas JP, Férnandez-Gaxiola AC, Rayco-Solon P. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database Syst Rev 2015; (12): CD007950.
  • 8. Harding KB, Peña-Rosas JP, Webster AC, et al. Iodine supplementation for women during the preconception, pregnancy and postpartum period. Cochrane Database Syst Rev 2017; (3): CD011761.
  • 9. Schummers L, Hutcheon JA, Bodnar LM, et al. Risk of adverse pregnancy outcomes by prepregnancy body mass index: a population-based study to inform prepregnancy weight loss counseling. Obstet Gynecol 2015; 125: 133-143.
  • 10. Boggess KA, Edelstein BL. Oral health in women during preconception and pregnancy: implications for birth outcomes and infant oral health. Matern Child Health J 2006; 10: 169-174.
  • 11. Blatt K, Moore E, Chen A, et al. Association of reported trimester-specific smoking cessation with fetal growth restriction. Obstet Gynecol 2015; 125: 1452-1459.
  • 12. Lassi ZS, Imam AM, Dean SV, Bhutta ZA. Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure. Reprod Health 2014; 11: S6.
  • 13. Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA 2006; 295: 1809-1823.
  • 14. Hanley GE, Hutcheon JA, Kinniburgh BA, Lee L. Interpregnancy interval and adverse pregnancy outcomes: an analysis of successive pregnancies. Obstet Gynecol 2017; 129: 408-415.
  • 15. Guerin A, Nisenbaum R, Ray JG. Use of maternal GHb concentration to estimate the risk of congenital anomalies in the offspring of women with prepregnancy diabetes. Diabetes Care 2007; 30: 1920-1925.
  • 16. Lassi ZS, Imam AM, Dean SV, Bhutta ZA. Preconception care: screening and management of chronic disease and promoting psychological health. Reprod Health 2014; 11: S5.
  • 17. Australian Government Department of Health. Immunisation for pregnancy. (viewed Sept 2018).
  • 18. Zaballa K, Liu A, Peek MJ, et al. Association between World Health Organization categories of body mass index and relative risks for weight-related pregnancy outcomes: a retrospective cohort study. Obstet Med 2012; 5: 112-118.
  • 19. Oteng-Ntim E, Mononen S, Sawicki O, et al. Interpregnancy weight change and adverse pregnancy outcomes: a systematic review and meta-analysis. BMJ Open 2018; 8: e018778.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.