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Brief Summary

GUIDELINE TITLE

Recommendations to improve preconception health and health care - United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care.

BIBLIOGRAPHIC SOURCE(S)

GUIDELINE STATUS

This is the current release of the guideline.

BRIEF SUMMARY CONTENT

 
RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

Recommendation 1. Individual Responsibility Across the Lifespan. Each woman, man, and couple should be encouraged to have a reproductive life plan.

Recommendation 2. Consumer Awareness. Increase public awareness of the importance of preconception health behaviors and preconception care services by using information and tools appropriate across various ages; literacy, including health literacy; and cultural/linguistic contexts.

Recommendation 3. Preventive Visits. As a part of primary care visits, provide risk assessment and educational and health promotion counseling to all women of childbearing age to reduce reproductive risks and improve pregnancy outcomes.

Recommendation 4. Interventions for Identified Risks. Increase the proportion of women who receive interventions as follow-up to preconception risk screening, focusing on high priority interventions (i.e., those with evidence of effectiveness and greatest potential impact).

Recommendation 5. Interconception Care. Use the interconception period to provide additional intensive interventions to women who have had a previous pregnancy that ended in an adverse outcome (i.e., infant death, fetal loss, birth defects, low birthweight, or preterm birth).

Recommendation 6. Prepregnancy Checkup. Offer, as a component of maternity care, one prepregnancy visit for couples and persons planning pregnancy.

Recommendation 7. Health Insurance Coverage for Women with Low Incomes. Increase public and private health insurance coverage for women with low incomes to improve access to preventive women's health and preconception and interconception care.

Recommendation 8. Public Health Programs and Strategies. Integrate components of preconception health into existing local public health and related programs, including emphasis on interconception interventions for women with previous adverse outcomes.

Recommendation 9. Research. Increase the evidence base and promote the use of the evidence to improve preconception health.

Recommendation 10. Monitoring Improvements. Maximize public health surveillance and related research mechanisms to monitor preconception health.

CLINICAL ALGORITHM(S)

None provided

EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of evidence supporting the recommendations is not specifically stated.

IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2006 Apr 21

GUIDELINE DEVELOPER(S)

Centers for Disease Control and Prevention - Federal Government Agency [U.S.]

SOURCE(S) OF FUNDING

United States Government

GUIDELINE COMMITTEE

CDC/ATSDR Preconception Care Work Group

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

CDC/ATSDR Preconception Care Work Group

Agency for Toxic Substances and Disease Registry: Robert H. Johnson, MD, Division of Health Education and Promotion

CDC Office of the Director: Yvonne Green, MSN, Office of Women's Health

Coordinating Center for Environmental Health and Injury Prevention: Elizabeth H. Howze, ScD, Office of the Director

National Center for Chronic Disease Prevention and Health Promotion: Carmen Ayala, Division of Adult and Community Health; Linda Bradley, PhD, Office of Genetics and Disease Prevention; William M. Callaghan, MD, Division of Reproductive Health; Paul Idahosa Eke, PhD, Division of Oral Health; Carol McGowen, MPH, Division of Nutrition and Physical Activity; Michelle D. Owens, PhD, Division of Diabetes Translation; Samuel F. Posner, PhD, Division of Reproductive Health; Abby C. Rosenthal, MPH, Office on Smoking and Health; Tishia G. Smith, MPH, Division of Reproductive Health; Mary Vernon-Smiley, Division of Adolescent and School Health

National Center for Health Marketing: Lisa Koonin, MPH, Division of Private and Public Partnerships

National Center for HIV, STD, and TB Prevention: John Anderson, PhD, Division of HIV/AIDS Prevention; Margaret A. Lampe, MPH, Division of HIV/AIDS Prevention; Cathleen M. Walsh, DrPH, Division of STD Prevention

National Center for Infectious Diseases: Stephanie Schrag, PhD, Division of Bacterial and Mycotic Diseases; Susan A. Wang, MD, Division of Viral Hepatitis

National Center on Birth Defects and Developmental Disabilities: Myron Adams, MD, Office of the Director; Hani K. Atrash, MD, Office of the Director; Michele G. Beckman, MPH, Division of Hereditary Blood Disorders; Adam Brush, MPH, Office of the Director; José F. Cordero, MD, Office of the Director; Nicole Dowling, PhD, Division of Hereditary Blood Disorders; Shahul Ebrahim, Division of Birth Defects and Developmental Disabilities; Erika L. Edding, Office of the Director; Elizabeth M. Fassett, MS, Division of Human Development and Disability; R. Louise Floyd, DSN, Division of Birth Defects and Developmental Disabilities; Scott Grosse, PhD, Office of the Director; Namita S. Joshi, MA, Office of the Director; Joe Mulinare, MD, Division of Human Development and Disability; Christopher S. Parker, PhD, Office of the Director; Christine E. Prue, PhD, Office of the Director; Danielle S. Ross, PhD, Division of Human Development and Disability; JoAnn M. Thierry, PhD, Division of Human Development and Disability

National Immunization Program: Susan Reef, MD, Division of Epidemiology and Surveillance

Select Panel on Preconception Care

Hani Atrash, MD, National Center on Birth Defects and Developmental Disabilities, CDC; Greg R. Alexander, ScD, College of Medicine, University of South Florida, Tampa, Florida; Maribeth Badura, MPH, Maternal and Child Health Bureau, Health Resources and Services Administration, Washington, District of Columbia; Peter Bernstein, MD, Albert Einstein College of Medicine, Bronx, New York; Janis Biermann, MS, March of Dimes, White Plains, New York; Kim A. Boggess, MD, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Joseph N. Bottalico, DO, American Osteopathic Association/American College of Osteopathic Obstetricians and Gynecologists, Fort Worth, Texas; Sheree Boulet, DrPH, National Center on Birth Defects and Developmental Disabilities, CDC; Carol Brady, MA, Northeast Florida Healthy Start Coalition, Jacksonville, Florida; Al Brann, Jr., MD, Emory University School of Medicine, Atlanta, Georgia; Magdalena Castro-Lewis, National Alliance for Hispanic Health, Washington, District of Columbia; Robert Cefalo, MD, University of North Carolina, Chapel Hill, North Carolina; José F. Cordero, MD, National Center on Birth Defects and Developmental Disabilities, CDC; Arlene Cullum, MPH, Sutter Medical Center, Sacramento, California; Michele Curtis, MD, University of Texas-Houston Health Science Center, Houston, Texas; Susan Halebsky Dimock, PhD, Jacobs Institute of Women's Health, Washington, District of Columbia; Anne Lang Dunlop, MD, Emory University School of Medicine, Atlanta, Georgia; Margaret Comerford Freda, EdD, Albert Einstein College of Medicine, Bronx, New York; Keith A. Frey, MD, Mayo Clinic, Scottsdale, Arizona; David Grainger, MD, University of Kansas School of Medicine, Wichita, Kansas; Holly Grason, MA, John Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Maxine Hayes, MD, Washington State Department of Health, Olympia, Washington; Jennifer Hoskovec, MS, University of Texas Medical School Houston, Houston, Texas; Brian Jack, MD, Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts; Carole Johnson, MA, Alliance of Community Health Plans, Washington, District of Columbia; Kay Johnson, MEd, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Wanda K. Jones, DrPH, Office on Women's Health, US Department of Health and Human Services, Washington, District of Columbia; Lois Jovanovic, MD, Sansum Diabetes Research Institute, Santa Barbara, California; Lorraine Klerman, DrPH, Brandeis University Waltham, Massachusetts; Ann M. Koontz, Maternal and Child Health Bureau, Health Resources and Services Administration, Washington, District of Columbia; Carol Korenbrot, PhD, University of California, San Francisco, California; Milton Kotelchuck, PhD, Boston University School of Public Health, Boston, Massachusetts; George Little, MD, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Charles S. Mahan, MD, University of South Florida, Tampa, Florida; Melissa McDiarmid, MD, University of Maryland School of Medicine, Baltimore, Maryland; Susan Meikle, MD, Agency for Healthcare Research and Quality, Washington, District of Columbia; Cathy L. Melvin, PhD, University of North Carolina, Chapel Hill, North Carolina; Merry K. Moos, MPH, University of North Carolina, Chapel Hill, North Carolina; Anne Marie Murphy, PhD, Illinois Department of Public Aid, Springfield, Illinois; Christopher S. Parker, PhD, National Center on Birth Defects and Developmental Disabilities, CDC; Magda Peck, ScD, CityMatCH, Omaha, Nebraska; Annette Phelps, Florida Department of Health, Tallahassee, Florida; Albert Pizzica, National Perinatal Association, Harrisburg, Pennsylvania; Samuel F. Posner, PhD, National Center for Chronic Disease Prevention and Health Promotion, CDC; Winston Price, MD, National Medical Association, Washington, District of Columbia; Elena Rios, MD, National Hispanic Medical Association, Washington, District of Columbia; Sara Rosenbaum, JD, George Washington University Medical Center, Washington, District of Columbia; Anne Santa-Donato, MSN, Association of Women's Health, Obstetric and Neonatal Nurses, Washington, District of Columbia; Catherine Y. Spong, MD, National Institute for Child and Health and Human Development, National Institutes of Health, Washington, District of Columbia; Ann Weathersby, Kaiser Permanente, Lithonia, Georgia; Carol S. Weisman, PhD, Pennsylvania State College of Medicine, State College, Pennsylvania; Katharine Wenstrom, MD, University of Alabama at Birmingham, Birmingham, Alabama; Terri D. Wright, W.K. Kellogg Foundation, Battle Creek, Michigan

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

The Centers for Disease Control and Prevention (CDC), their planners, and their content experts wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters.

GUIDELINE STATUS

This is the current release of the guideline.

GUIDELINE AVAILABILITY

Electronic copies: Available from the Centers for Disease Control and Prevention (CDC) Web site:

Print copies: Available from the Centers for Disease Control and Prevention, MMWR, Atlanta, GA 30333. Additional copies can be purchased from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402-9325; (202) 783-3238.

AVAILABILITY OF COMPANION DOCUMENTS

PATIENT RESOURCES

None available

NGC STATUS

This NGC summary was completed by ECRI on May 17, 2006.

COPYRIGHT STATEMENT

No copyright restrictions apply.

DISCLAIMER

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