Preconception Care: A Comparative Review of Major Guidelines
Notice bibliographique
Résumé
Importance: Preconception care represents a crucial aspect of healthy pregnancy as it aims to optimize the health status of women and men before conception by mitigating the modifiable individual and environmental risk factors and providing education, counseling, and timely interventions. Objective: The aim of this study was to review and compare the most recently published influential guidelines on prepregnancy counseling and management of chronic medical conditions. Evidence Acquisition: A descriptive review of guidelines from the American College of Obstetricians and Gynecologists (ACOG), the Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG), and the Public Health Agency of Canada (PHAC) on preconception care was carried out. Results: There is a consensus among the reviewed guidelines that a detailed personal and family history and risk factor assessment and counseling against smoking, alcohol, and substance abuse are the main areas to focus when providing preconception care. In addition, assessment of immunization status and screening for intimate partner violence and sexual coercion, as well as screening for human papillomavirus and cervical cancer, are unanimously recommended. All medical societies also agree that counseling on diet, body mass index, and physical activity should be routinely offered along with a review of supplements and advice on folic acid supplementation. Furthermore, the need of medication review for potential teratogenic effects and the importance of assessing for environmental and occupational exposure to teratogens are underlined by all guidelines. Moreover, ACOG and PHAC recommend a discussion regarding contraception, support an optimal interpregnancy interval of at least 18 months, and underline that screening for sexually transmitted infections should be offered only in cases with existing risk factors. ACOG and RANZCOG also suggest that patients should be offered guidance on proper food handling and traveling restrictions to prevent certain infectious diseases. Finally, ACOG and PHAC provide guidance on the preconception management of chronic medical conditions, whereas RANZCOG, although mentioning that all preexisting medical conditions should be optimized before achieving pregnancy, provides no further guidance. Conclusion: Preparing for a healthy pregnancy not only drives favorable perinatal outcomes, but is also associated with long-lasting benefits for the offspring. Health care professionals are ideally positioned to offer clear, accurate, and timely counseling to the parents-to-be, screen for and act upon any potential impediments to a successful outcome, support the decision-making process, and offer referral to relevant services when required. Therefore, the development of consistent international guidelines on preconception care to guide clinical practice seems of insurmountable importance.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,048 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,005 | 0,001 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».