Limits...
Preconception care: promoting reproductive planning.

Dean SV, Lassi ZS, Imam AM, Bhutta ZA - Reprod Health (2014)

Bottom Line: Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths.Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care.Promoting reproductive planning on a wider scale is closely interlinked with the reliable provision of effective contraception, however, innovative strategies will need to be devised, or existing strategies such as community-based health workers and peer educators may be expanded, to encourage girls and women to plan their families.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Preconception care recognizes that many adolescent girls and young women will be thrust into motherhood without the knowledge, skills or support they need. Sixty million adolescents give birth each year worldwide, even though pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20-29 years. Reproductive planning and contraceptive use can prevent unintended pregnancies, unsafe abortions and sexually-transmitted infections in adolescent girls and women. Smaller families also mean better nutrition and development opportunities, yet 222 million couples continue to lack access to modern contraception.

Method: A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.

Results: Comprehensive interventions can prevent first pregnancy in adolescence by 15% and repeat adolescent pregnancy by 37%. Such interventions should address underlying social and community factors, include sexual and reproductive health services, contraceptive provision; personal development programs and emphasizes completion of education. Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths.

Conclusion: Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care. Promoting reproductive planning on a wider scale is closely interlinked with the reliable provision of effective contraception, however, innovative strategies will need to be devised, or existing strategies such as community-based health workers and peer educators may be expanded, to encourage girls and women to plan their families.

Show MeSH

Related in: MedlinePlus

Advanced maternal age and risk of stillbirths: evidence from observational studies Citation to the included studies: Abu-Heija 2000 [161], Astolfi 2002 [162], Astolfi 2005 [163], Blanco 1996 [138], Canterino 2004 [164], Cnattingius 1998 [143], Conde-Agudelo 2000 [196], Donoso 2003[166], Feldman 1992 [167], Feresu 2005 [168], Fretts 1995 [169], Fretts 1997 [170], Gadow 1991 [171], Gliniania 2005 [172], Haglund 1993 [173], Heimann 1993 [174], Jacobsson 2004 [147], Jolly 2000 [148], Khandait 2002 [175], Kristensen 2005 [176], Lammer 1989 [177], Miller 2005 [153], Naeye 1983 [178], Nybo 2000 [179], Pugliese 1997 [180], Rasmussen 2003 [181], Raymond 1994 [182], Reddy 2006 [183], Roman 2004 [184], Seoud 2002 [185], Sheiner 2000 [186], Tough 2002 [187], Viegas 1884 [188], Ziadeh 2002 [189], Ferraz 1991 [190], Little 1993 [191], Meda 1991 [192], Petridou 1996 [193], Smeeton 2004 [194], Stephansson 2001 [197]
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4196558&req=5

Figure 5: Advanced maternal age and risk of stillbirths: evidence from observational studies Citation to the included studies: Abu-Heija 2000 [161], Astolfi 2002 [162], Astolfi 2005 [163], Blanco 1996 [138], Canterino 2004 [164], Cnattingius 1998 [143], Conde-Agudelo 2000 [196], Donoso 2003[166], Feldman 1992 [167], Feresu 2005 [168], Fretts 1995 [169], Fretts 1997 [170], Gadow 1991 [171], Gliniania 2005 [172], Haglund 1993 [173], Heimann 1993 [174], Jacobsson 2004 [147], Jolly 2000 [148], Khandait 2002 [175], Kristensen 2005 [176], Lammer 1989 [177], Miller 2005 [153], Naeye 1983 [178], Nybo 2000 [179], Pugliese 1997 [180], Rasmussen 2003 [181], Raymond 1994 [182], Reddy 2006 [183], Roman 2004 [184], Seoud 2002 [185], Sheiner 2000 [186], Tough 2002 [187], Viegas 1884 [188], Ziadeh 2002 [189], Ferraz 1991 [190], Little 1993 [191], Meda 1991 [192], Petridou 1996 [193], Smeeton 2004 [194], Stephansson 2001 [197]

Mentions: We also found a higher (62%) risk of stillbirths with delayed childbearing, which is statistically significant and was derived from a total of 40 cohort and case-control studies (Figure 5). Although fewer studies were included in the meta-analyses for advanced maternal age and the risk of perinatal death (increased risk by 44%; 95% CI: 1.10-1.89), preterm birth (increased risk by 29% 95% CI: 1.14-1.46) and low birth weight (increased risk by 61%; 95% CI: 1.16-2.24), the analysis yielded significant effects for maternal age greater than 35 years on each of these outcomes.


Preconception care: promoting reproductive planning.

Dean SV, Lassi ZS, Imam AM, Bhutta ZA - Reprod Health (2014)

Advanced maternal age and risk of stillbirths: evidence from observational studies Citation to the included studies: Abu-Heija 2000 [161], Astolfi 2002 [162], Astolfi 2005 [163], Blanco 1996 [138], Canterino 2004 [164], Cnattingius 1998 [143], Conde-Agudelo 2000 [196], Donoso 2003[166], Feldman 1992 [167], Feresu 2005 [168], Fretts 1995 [169], Fretts 1997 [170], Gadow 1991 [171], Gliniania 2005 [172], Haglund 1993 [173], Heimann 1993 [174], Jacobsson 2004 [147], Jolly 2000 [148], Khandait 2002 [175], Kristensen 2005 [176], Lammer 1989 [177], Miller 2005 [153], Naeye 1983 [178], Nybo 2000 [179], Pugliese 1997 [180], Rasmussen 2003 [181], Raymond 1994 [182], Reddy 2006 [183], Roman 2004 [184], Seoud 2002 [185], Sheiner 2000 [186], Tough 2002 [187], Viegas 1884 [188], Ziadeh 2002 [189], Ferraz 1991 [190], Little 1993 [191], Meda 1991 [192], Petridou 1996 [193], Smeeton 2004 [194], Stephansson 2001 [197]
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4196558&req=5

Figure 5: Advanced maternal age and risk of stillbirths: evidence from observational studies Citation to the included studies: Abu-Heija 2000 [161], Astolfi 2002 [162], Astolfi 2005 [163], Blanco 1996 [138], Canterino 2004 [164], Cnattingius 1998 [143], Conde-Agudelo 2000 [196], Donoso 2003[166], Feldman 1992 [167], Feresu 2005 [168], Fretts 1995 [169], Fretts 1997 [170], Gadow 1991 [171], Gliniania 2005 [172], Haglund 1993 [173], Heimann 1993 [174], Jacobsson 2004 [147], Jolly 2000 [148], Khandait 2002 [175], Kristensen 2005 [176], Lammer 1989 [177], Miller 2005 [153], Naeye 1983 [178], Nybo 2000 [179], Pugliese 1997 [180], Rasmussen 2003 [181], Raymond 1994 [182], Reddy 2006 [183], Roman 2004 [184], Seoud 2002 [185], Sheiner 2000 [186], Tough 2002 [187], Viegas 1884 [188], Ziadeh 2002 [189], Ferraz 1991 [190], Little 1993 [191], Meda 1991 [192], Petridou 1996 [193], Smeeton 2004 [194], Stephansson 2001 [197]
Mentions: We also found a higher (62%) risk of stillbirths with delayed childbearing, which is statistically significant and was derived from a total of 40 cohort and case-control studies (Figure 5). Although fewer studies were included in the meta-analyses for advanced maternal age and the risk of perinatal death (increased risk by 44%; 95% CI: 1.10-1.89), preterm birth (increased risk by 29% 95% CI: 1.14-1.46) and low birth weight (increased risk by 61%; 95% CI: 1.16-2.24), the analysis yielded significant effects for maternal age greater than 35 years on each of these outcomes.

Bottom Line: Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths.Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care.Promoting reproductive planning on a wider scale is closely interlinked with the reliable provision of effective contraception, however, innovative strategies will need to be devised, or existing strategies such as community-based health workers and peer educators may be expanded, to encourage girls and women to plan their families.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Preconception care recognizes that many adolescent girls and young women will be thrust into motherhood without the knowledge, skills or support they need. Sixty million adolescents give birth each year worldwide, even though pregnancy in adolescence has mortality rates at least twice as high as pregnancy in women aged 20-29 years. Reproductive planning and contraceptive use can prevent unintended pregnancies, unsafe abortions and sexually-transmitted infections in adolescent girls and women. Smaller families also mean better nutrition and development opportunities, yet 222 million couples continue to lack access to modern contraception.

Method: A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture.

Results: Comprehensive interventions can prevent first pregnancy in adolescence by 15% and repeat adolescent pregnancy by 37%. Such interventions should address underlying social and community factors, include sexual and reproductive health services, contraceptive provision; personal development programs and emphasizes completion of education. Appropriate birth spacing (18-24 months from birth to next pregnancy compared to short intervals <6 months) can significantly lower maternal mortality, preterm births, stillbirths, low birth weight and early neonatal deaths.

Conclusion: Improving adolescent health and preventing adolescent pregnancy; and promotion of birth spacing through increasing correct and consistent use of effective contraception are fundamental to preconception care. Promoting reproductive planning on a wider scale is closely interlinked with the reliable provision of effective contraception, however, innovative strategies will need to be devised, or existing strategies such as community-based health workers and peer educators may be expanded, to encourage girls and women to plan their families.

Show MeSH
Related in: MedlinePlus