Table 1 Components of preconception care

Screening/ Risk assessment

Reproductive life plan: e. g. assess if a woman plans to have children, how long she plans to wait until she becomes pregnant, help her develop a plan

Reproductive history: Check previous adverse pregnancy outcomes e.g. infant death, fetal loss, birth defects, low birth weight, preterm birth

Medical history: Screen for chronic conditions like hypertension, diabetes

Medication use: Review the woman’s current medication use; avoid medications that had an impact on pregnancy unless their benefits out weight risks

Infections: Screen for periodontal, urogenital, and STIs as indicated

Genetic screening and family history: Assess the woman’s risk of chromosomal or genetic disorders.

Nutritional assessment: e.g. assess body mass index, screen for anemia

Substance abuse: Ask the woman about tobacco, alcohol, and drug use

Psychosocial concerns: Screen for depression, anxiety, domestic violence

Physical examination: e.g. pelvic examinations

Laboratory testing: e.g. blood type, screening for HIV/AIDS, hepatitis B

Counseling/Health promotion

Family planning: Promote family planning for women who are not planning to become pregnant, discuss emergency contraception.

Healthy weight and nutrition: Promote a healthy prepregnancy weight through exercise and nutrition; discuss macro­ micronutrients such as folic acid, iron

Healthy behaviors: Promote healthy behaviors such as nutrition, exercise, safe sex, and discourage risky behaviors such as smoking, alcohol, khat

Stress resilience: e.g. Promote sufficient sleep, relaxation techniques

Healthy environments: Discuss exposures to heavy metals, organic solvents, pesticides, and allergens; give practical tips such as how to avoid exposures.

Interventions/ Management

Address the identified medical and psychosocial risks: e.g. folic acid supplementation, and vaccination if indicated, control of pregestational diabetes

Referral to specialized preconception care if indicated