A case for preconceptual education programs for women: Integrative review

Abstract

Exposure to environmental factors before conception or in the very early stage of the embryonic period, can cause permanent changes in an individual life that can result in the development of chronic illness later in life or be transferred to progeny and hence future generations. Diverse effects of poor diet, alcohol, tobacco consumption, infectious diseases, obesity, anxiety, and depression in pregnancy and fetal origin of adult diseases all are well documented and known. Many of these are preventable or can be modified or treated. The general provision of prepregnancy interventions, however, are neglected by current health system policy. According to the World Health Organization (WHO), 50% of pregnancies worldwide are unintentional. The consequences of this is that embryo exposure to the teratogens can occur weeks before the pregnancy has been detected. Most women modify their risky behavior, such as smoking cessation, reducing alcohol consumption and even alter their lifestyle to a healthier one, such as consuming folic acid and multivitamins, when they learn about their pregnancy, typically around 8-10 weeks of gestational age. By this time, however, women have missed the opportunity of providing a healthy uterine environment for their fetus through the critical stage of the embryonic period. Preconception care is a relatively new concept and provides a unique opportunity to improve maternal health and pregnancy outcomes before pregnancy, through pregnancy, and after birth. Despite the general acknowledgment of the potential valuable impact of preconception care, there are various impediments to implementation of preconception care as part of routine practice in the health system.