Premium
Understanding and provision of preconception care by general practitioners
Author(s) -
Kizirian Nathalie V.,
Black Kirsten I.,
Musgrave Loretta,
Hespe Charlotte,
Gordon Adrienne
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12962
Subject(s) - medicine , psychological intervention , overweight , family medicine , pregnancy , nursing , obesity , biology , genetics
Background Preconception care ( PCC ) defines health interventions prior to conception aimed at improving pregnancy and infant outcomes. Aim To explore the understanding and provision of PCC by general practitioners ( GP s) within the Sydney Local Health District. Materials and Methods A questionnaire developed with GP s assessed structure and content of PCC provided, attitudes toward PCC and perceived barriers and facilitators. Results One hundred and ten GP s completed the survey: 84% reported that GP s should be the main providers of PCC; however, only 53% were aware of PCC guidelines. Seventy‐five percent of responders initiated PCC discussion with women of reproductive age, 56% provided PCC to women at higher risk of adverse outcomes and 16% waited for the discussion to be initiated by the patient. Smoking, vaccination, alcohol and supplements/medication use were the most discussed PCC components, while serology, full blood count and blood pressure were the most performed assessments. Most respondents stated that PCC is essential for women with pre‐existing diabetes, previous pregnancy complications or chronic illness. However, only 45% stated PCC was essential for women >35 years and 39% for women who were overweight. Importantly, weight and mental health were among the least discussed PCC components. Conclusion General practitioners are key providers of PCC; however, only half are aware of PCC guidelines and most do not recognise overweight to be a significant preconception issue. The most common barriers to PCC delivery were time constraints, lack of knowledge and lack of resources for patients. Improved resources and education are required to support adequate PCC provision.