Highlights
- •A paucity of data exists describing pregnancy outcomes for women receiving preconception counselling.
- •Improved outcomes are described in the studies that we identified.
- •This supports the routine inclusion of PCC for women with chronic medical conditions.
- •Further studies are required to broaden the evidence base.
Abstract
Background
Beyond diabetes mellitus little data reports outcomes of women with chronic medical
conditions who have received pre-conception counselling (PCC). This study aimed to
perform a systematic review of the literature to evaluate evidence regarding the impact
of PCC on maternal and fetal outcomes in women with chronic medical conditions aside
from diabetes mellitus.
Methods
A systematic review was conducted in accordance with PRISMA. PubMed, Cochrane, Ovid
Medline and Web of Science were searched. Two reviewers screened abstracts and full
texts. Inclusion criteria included studies relating to chronic medical disorders of
interest published between database inception and 21st May 2022, reporting outcomes relating to disease activity and perinatal outcomes.
Results
The search yielded 11,814 results of which six met criteria for inclusion. Two papers
describe the demographics of women more likely to receive PCC which included younger
age, shorter disease duration, nulliparity, IVF pregnancy and higher education/job
security. Two reported the effects of PCC on women's behaviour with improvements demonstrated
in correct medication adherence, folic acid intake and smoking cessation. Five studies
reported outcomes related to disease activity; those receiving PCC were more likely
to have quiescent disease during pregnancy. Improvements in pregnancy outcomes were
described including reduced rates of small for gestational age, low birth weight,
preterm birth, congenital abnormality and obstetric complications.
Discussion
A paucity of data exists relating to pregnancy outcomes in women with chronic medical
conditions receiving PCC. Reported outcomes are favorable, supporting the routine
inclusion of PCC in preparation for pregnancy in such patients.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
AED (Antiepileptic Drug), APGAR (Appearance, Pulse, Grimace, Activity, and Respiration), APS (Antiphospholipid Syndrome), COVID-19 (Coronavirus-19), CVD (Cardiovascular Disease), HCP (Healthcare Professional), IBD (Inflammatory Bowel Disease), IVF (In Vitro Fertilisation), MeSH (Medical Sibject Headings), NTD (Neural Tube Defect), PCC (Preconception Counselling), PRISMA (Preferred Reporting System for Systematic Reviews and Meta-Analysis), RA (Rheumatoid Arthritis), ROBIS (Risk Of Bias In Systematic review), SLE (Systemic Lupus Erythematous), SUDEP (Sudden or Unexpected Death in Epilepsy)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: November 23, 2022
Accepted:
November 1,
2022
Received in revised form:
October 29,
2022
Received:
August 28,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
