Comparison of the detection rates of preconception health risks among Chinese couples of reproductive age in 2013 and 2019 / 中华健康管理学杂志

Objective:To assess the detection rates of preconception health risks among couples of reproductive age in China and analyze the differences between 2013 and 2019.Methods:In this cross-sectional study, the preconception health examination data of 9 153 916 couples of 20-49 years who participated in the National Free Preconception Health Examination Project in 2013 or 2019 were consecutively selected. The health risks involved eight aspects in women (genetic risk, reproductive risk, chronic disease risk, infectious risk, nutritional risk, behavioral risk, environmental risk and psychosocial risk) and seven aspects in men except for reproductive risks were assessed. The t test and χ2 test were used to compare the differences in demographic characteristics between the couples of reproductive age. The detection rates and 95% CI of each preconception health risk were calculated and the χ2 test was used to compare the differences in the detection rates of risk factors. Results:In 2019, the proportion of couples of reproductive age in China who were 35 years or older, had an education background of high school and above, workers, and held non-agricultural registered residence were all higher than those in 2013 (15.18% vs 6.22%, 52.12% vs 29.78%, 8.33% vs 7.17%, 12.39% vs 6.64%), while the proportion of farmers was significantly lower than that in 2013 (60.95% vs 76.87%) (all P<0.001). In 2013, the three health risks with the highest detection rate among Chinese women of reproductive age was nutritional risk (37.50%), infectious risk (16.95%) and psychosocial risk (11.62%), respectively; while in 2019, it was nutritional risk (38.07%), infectious risk (12.82%), and chronic disease risk (11.12%), respectively. The detection rate of nutritional risk in Chinese women of reproductive age in 2019 was significantly higher than that in 2013 (38.07% vs 37.50%), while the detection rates of infectious risk and psychosocial risk were both lower than those in 2013 (12.82% vs 16.95% and 7.37% vs 11.62%) (all P<0.001). In 2013, the top three risks detected in men of reproductive age was behavioral risk (44.87%), nutritional risk (36.81%) and psychosocial risk (13.43%), respectively; and in 2019, it was nutritional risk (45.47%), behavioral risk (38.76%) and psychosocial risk (9.18%), respectively. The detection rates of nutritional risk in men of reproductive age in 2019 was significantly higher than that in 2013 (45.47% vs 36.81%), while the detection rates of behavioral risk and psychosocial risk were both lower than those in 2013 (38.76% vs 44.87%, 9.18% vs 13.43%) (all P<0.001). Conclusions:The detection rate of nutritional risk in couples of reproductive age and genetic risk in men in 2019 in China are higher than those in 2013, and the exposure to the other preconception health risks is decreasing. The nutritional risk, infection risk, psychosocial risk and chronic disease risk are the main risk factors for women of reproductive age, while the nutritional risk, behavioral risk and psychosocial risk are the main risk factors for men.

Intervención educativa sobre riesgo preconcepcional en mujeres de un Área de salud en Guantánamo / Knowledge intervention on preconception risk in women from a health area in Guantánamo

Fundamento: La salud reproductiva está presente durante el ciclo vital de las mujeres y los hombres; en la que juega un papel decisivo la planificación familiar, el conocimiento y manejo del riesgo reproductivo. Objetivo: Evaluar la efectividad de una intervención educativa, en mujeres de edad fértil con riesgo preconcepcional, pertenecientes al consultorio "La Colonia", del Policlínico "Rafael Teope Fonseca", "El Salvador", Guantánamo, desde septiembre 2017 a abril 2019. Metodología: Se realizó un estudio cuasiexperimental, tipo intervención educativa sobre riesgo preconcepcional, con diseño antes y después. El universo fue de 65 mujeres en edad fértil. Se utilizó muestreo no probabilístico intencional. La muestra fue de 45 mujeres con riesgo preconcepcional. La investigación se realizó en 3 etapas: diagnóstica, intervención y evaluación. La información se recogió en una encuesta semiestructurada que se aplicó antes y después de la intervención. Las variables fueron: métodos para planificar el embarazo, edad óptima para el embarazo, antecedentes obstétricos desfavorables, importancia del consumo de ácido fólico antes del embarazo y conocimiento general sobre el tema. Se determinó el test de McNemar para el análisis estadístico e índice de kappa para determinar efectividad de la intervención. Resultados: Antes de la intervención se diagnosticó nivel de conocimiento inadecuado sobre los métodos para planificar el embarazo (42 %), edad óptima para el embarazo (40 %) y en los antecedentes obstétricos (36 %). Posterior a la intervención el nivel de conocimiento adecuado fue significativo (p<0.05) en todas las variables. El índice kappa arrojó acuerdo considerable. Conclusiones: La intervención educativa fue efectiva.

Background: Reproductive health is present during women and men's life cycle, so family planning, knowledge and management of reproductive risk play a significant role. Objective: To evaluate the effectiveness of a knowledge intervention in fertile age women with preconception risk, at "La Colonia" clinic, in "Rafael Teope Fonseca" Polyclinic, "El Salvador", Guantánamo, from September 2017 to April 2019. Methodology: A quasi-experimental study was conducted, of educational intervention type on preconception risk, with formerly and subsequently designs. The universe was 65 women of fertile age. Intentional non-probabilistic sampling was used. The sample was 45 women with preconception risk. The research was conducted in 3 stages: diagnosis, intervention and evaluation. The information was collected in a semi-structured survey applied before and after the intervention. The variables were: methods for planning pregnancy, optimal age for pregnancy, unfavorable obstetric history, importance of folic acid intake before pregnancy, and general knowledge on the subject. The McNemar test was determined for the statistical analysis and the Kappa index to determine the effectiveness of the intervention. Results: Before the intervention, an inadequate level of knowledge was diagnosed about the methods for planning pregnancy (42 %), the optimal age for pregnancy (40 %) and the obstetric history (36 %). After the intervention, the adequate level of knowledge was significant (p<0.05) in all the variables. The Kappa index showed considerable agreement. Conclusions: The educational intervention was effective.

Do Our Diabetic Patients Ready for Safe Pregnancy? Attitude Towards Preconception Care and Its Associated Factors Among Women With Diabetes Attending Government Health Clinics in Terengganu

@#Introduction: Women with uncontrolled diabetes may conceive but will result in poor pregnancy outcomes. This study aimed to assess the level of knowledge and attitude and determine factors associated with attitude towards preconception care. Method: A cross-sectional study was conducted in various government health clinics from all districts in Terengganu by using multistage random sampling. A self-administered questionnaire was applied to assess the level of knowledge and attitude towards preconception care. Multiple logistic regressions were applied to determine factors associated with attitude towards preconception care. Results: A total of 422 respondents were involved. The prevalence of respondents with unsatisfactory knowledge and attitude were 41.7% and 84.1%, respectively. Knowledge was not significantly associated with attitude. Respondents who used contraception had a better attitude (Adj. OR: 0.44, 95% CI:0.23,0.84). Low household income was associated (Adj. OR: 2.40, 95% CI:1.10,5.26) with an unsatisfactory attitude towards preconception care. Conclusion: Attitude towards preconception care amongst diabetic women who were attending primary care clinics was unsatisfactory. A structured and focused preconception educational programme care is necessary, especially amongst low-income women.

Effects of pre-pregnancy body mass index, gestational weight gain and early feeding behavior on lactogenesis stage Ⅱ: a prospective study / 中华围产医学杂志

Objective:To investigate the influence of pre-pregnancy body mass index (BMI), gestational weight gain and early feeding behavior on delayed onset of lactogenesis stage Ⅱ(DOL Ⅱ).Methods:This was a prospective study involving puerperae from Women's Hospital of Nanjing Medical University from March 2020 to June 2020. Demographic data and delivery data were obtained using questionnaires and breastfeeding behavior and milk secretion were followed up every day after delivery. According to whether the lactation initiation was longer than 72 h or not, all subjects were divided into DOL Ⅱ group or non-DOL Ⅱ group. Differences in general condition and breastfeeding between the two groups were compared using independent sample t-test, Chi-square test, and Mann-Whitney U test. Multivariate logistic regression analysis was used to analyze the risk factors of DOL Ⅱ. Results:During the study period, a total of 390 cases were enrolled and 334 cases among them were analyzed due to lost of follow-up in 56 cases. The incidence of DOL Ⅱ was 19.2% (64/334). Univariate analysis showed that body mass index [lean:18.8% (12/64) vs 13.3% (36/270); fit:56.2% (36/64) vs 74.8% (202/270); overweight: 25.0% (16/64) vs 11.9% (32/270); χ2=9.78], mode of delivery [vaginal delivery: 37.5% (24/64) vs 52.6% (142/270); cesarean section: 62.5% (40/64) vs 47.4% (128/270); χ2=4.71], nipple type score in LATCH score [2.0 (1.0-2.0) vs 2.0 (2.0-2.0), U=－2.08], frequency of breastfeeding in 24 h [(6.3±3.0) vs (8.3±3.6) times per day, t=－3.94], adding formula within 24 h [71.9% (46/64) vs 56.3% (152/270), χ2=5.20] and the proportion of attending breastfeeding clinic during pregnancy [73.4% (47/64) vs 85.6% (231/270), χ2=5.44] were significantly different between the DOL Ⅱ and non-DOL Ⅱ groups (all P<0.05). Multivariate logistic regression analysis showed that pre-pregnancy overweight was an independent risk factor for DOL Ⅱ ( OR=2.240, 95% CI:1.020-4.918, P=0.044), either was pre-pregnancy overweight with appropriate gestational weight gain ( OR=5.595, 95% CI:1.492-20.985, P=0.011), while breastfeeding frequency within 24 h ( OR=0.867, 95% CI: 0.780-0.963, P=0.008) and attending breastfeeding clinic during pregnancy ( OR=0.377, 95% CI: 0.173-0.820, P=0.014) were independent protective factors for DOL Ⅱ. Conclusions:Women who were overweight before pregnancy are more likely to suffer from DOL Ⅱ. Extra guidance should be given to this population during early breastfeeding. Attending prenatal breastfeeding consultation and increasing the frequency of breastfeeding in the early postpartum period may prevent DOL.

Influencing factors of intention to utilize preconception health care services among women with future pregnancy plan / 上海预防医学

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

Caracterización del riesgo reproductivo preconcepcional en las mujeres en edad fértil / Characterization of the reproductive pre-conception risk in the women in fertile age

RESUMEN Fundamento: un adecuado control y manejo del riesgo preconcepcional permite determinar el estado de salud de cada mujer, lo que hace posible asumir un embarazo con mejores resultados para el binomio mediante el control de los factores de riesgo. Objetivo: caracterizar el comportamiento del riesgo reproductivo preconcepcional. Métodos: se realizó un estudio observacional, descriptivo y transversal en los consultorios del médico y la enfermera de la familia del Policlínico Pedro Borrás Astorga del municipio Pinar del Río, durante el año 2019. El universo fue de 4 772 mujeres en edad fértil. Se utilizó la estadística descriptiva y los resultados se reflejaron en tablas. Resultados: se identificaron 848 mujeres con riesgo reproductivo preconcepcional, un gran número de mujeres presentan enfermedades crónicas no transmisibles y algunas tienen más de una enfermedad. Predominó la malnutrición por defecto y por exceso, la hipertensión arterial y el asma bronquial y como antecedentes obstétricos, los abortos provocados, el período intergenésico corto y la hipertensión inducida por el embarazo, las anemias y los hijos pretérminos anteriores o bajo peso al nacer. Un alto porciento se encuentra controlado con algunas dificultades con las adolescentes. Conclusiones: el riesgo reproductivo preconcepcional es una problemática aún sin resolver ya que hubo un número de las mujeres que no estaban controladas. El seguimiento adecuado de las parejas con riesgo preconcepcional y su responsabilidad en la planificación de un embarazo contribuye al mejoramiento de la calidad de vida de madres e hijos.

ABSTRACT Background: an appropriate control and handling of the pre-conception risk allows determining the state of each woman's health, making possible to assume a pregnancy with better results for the binomial by means of the control of the risk factors. Objective: to characterize the behavior of the reproductive pre-conception risk. Methods: an observational, descriptive and traverse study was the carried out in the family doctor's and nurse offices of the Pedro Borrás Astorga Policlinic in Pinar del Río in 2019. The universe was constituted by 4772 women in fertile age. The descriptive statistic was used and the results were reflected in charts. Results: 848 women were identified with reproductive pre-conception risk, a great number of women present non-transmissible chronic illnesses and some have more than one illness. The malnutrition prevailed as much for defect as for excess, the arterial hypertension and the bronchial asthma and as obstetric antecedents, the induced miscarriages, the short birth intervals and the hypertension induced by the pregnancy, the anemia's and the previous preterm children and/or low-birth-weight babies. A high percent is controlled with some difficulties with the adolescents. Conclusions: the reproductive pre-conception risk is still a problem without solving since there was a number of the woman that they were not controlled. The appropriate control of the couples with pre-conception risk and its responsibility in the planning of a pregnancy contributes the improvement of the quality of mothers' and children's life.

Influencia del riesgo preconcepcional en la salud materna / Influence of preconceptional risk on maternal health

RESUMEN El riesgo preconcepcional está condicionado por una serie de factores, enfermedades o circunstancias únicas o asociadas que pueden repercutir desfavorablemente en el binomio madre / hijo durante la gestación, parto o puerperio. La prevención de la enfermedad y la muerte durante el proceso de reproducción, es uno de los pilares fundamentales para el desarrollo de la salud reproductiva. La morbilidad materna constituye uno de los aspectos más importantes para reflexionar. El objetivo de esta investigación es valorar la influencia del riesgo preconcepcional en la salud materna. Es indispensable, no solo en la atención de las gestantes, sino también para aquellas mujeres que desean ser madres en algún momento de su vida. Se ha adoptado un nuevo enfoque hacia el riesgo preconcepcional con acciones que contribuyan a mejorar la salud sexual y reproductiva en esta etapa en la vida de hombres y mujeres.

ABSTRACT Preconception risk is conditioned by a series of factors, diseases or unique or associated circumstances that can have an unfavorable impact on the mother - child binomial during pregnancy, delivery or puerperium. The prevention of disease and death during the reproductive process is one of the fundamental pillars for the development of reproductive health. Maternal morbidity is one of the most important aspects to reflect on. The objective of this research is to assess the influence of preconception risk on maternal health. It is essential, not only in the care of pregnant women, but also for those women who want to be mothers at some point in their life. A new approach has been adopted towards preconception risk with actions that contribute to improve sexual and reproductive health at this stage in the lives of men and women.

Preconception Care to Improve Pregnancy Outcomes: The Science

INTRODUCTION: In the last decades, improvements in the care of pregnancy and child development have been observed worldwide. However, pregnancy problems remain high in most countries. There was a concentration of care in the prenatal period as the primary approach for improving pregnancy results. Currently, attention to the care of pregnant women, women who have recently given birth, and newborns are focused on the care of preconception to improve the results of pregnancy and improve the outcomes of child growth and developmentOBJECTIVE: Describe the evidence for preconception care (PCC) and information to the health care provider, as well as describe instruments to present health care providers with PCC, its definition, its components, recommended interventions, and the scientific basis for recommendationsMETHODS: There was a search for published and unpublished literature related to scientific evidence for the effectiveness of PCC in improving pregnancy results. The search was carried out based on Pubmed and using data scraping techniques, in the material available on the internet and disseminated by international organizations, such as the World Health Organization and reports by government agenciesRESULTS: It is reported that the literature on the scientific basis for PCC is fragmented, and most publications discuss evidence of one or a few interventions, with the majority of reports considering PCC for specific populations, such as women with chronic health problems and couples with infertility. However, these publications do not offer a realistic view of the proposed PCC interventions, with the scientific evidence that supports them. The general aspects of the existing literature and the recommended preconceived care interventions are described, together with the quality of the scientific evidence and the strength of the recommendations behind each of these interventionsCONCLUSION: Many clinical interventions have been identified that could be offered to women before conception to help avoid adverse outcomes. Most of these interventions have scientific evidence to support their role in improving pregnancy outcomes. Therefore, it is recommended that clinical care providers incorporate evidence-based prejudice services in their daily care of women of reproductive age, in an effort to improve women's health before and during pregnancy, as well as improve pregnancy outcomes for women and their children

INTRODUÇÃO: As Nas últimas décadas, foram observadas melhorias no cuidado à gravidez e no desenvolvimento infantil em todo o mundo. No entanto, os problemas de gravidez continuam altos na maioria dos países. Houve uma concentração de cuidados no período pré-natal como a principal abordagem para melhorar os resultados da gravidez. Atualmente, a atenção aos cuidados de mulheres grávidas, mulheres que deram à luz recentemente e recém-nascidos está focada no cuidado de preconcepção para melhorar os resultados da gravidez e os resultados do crescimento e desenvolvimento infantilOBJETIVO: Descrever as evidências para os cuidado preconcepção (PCC) e informações para o profissional da saúde, bem como descrever instrumentos para apresentar aos profissionais de saúde o PCC, sua definição, seus componentes, intervenções recomendadas e a base científica para recomendaçõesMÉTODO: Houve uma pesquisa de literatura publicada relacionada a evidências científicas para a eficácia do PCC na melhoria dos resultados da gravidez. A pesquisa foi realizada com base no Pubmed e utilizando técnicas de raspagem de dados, no material disponível na internet e divulgado por organizações internacionais, como a Organização Mundial da Saúde e relatórios de órgãos governamentaisRESULTADOS: Relata-se que a literatura sobre a base científica do PCC é fragmentada e a maioria das publicações discute evidências de uma ou poucas intervenções, com a maioria dos relatórios considerando o PCC para populações específicas, como mulheres com problemas crônicos de saúde e casais com infertilidade. No entanto, essas publicações não oferecem uma visão realista das intervenções propostas do PCC, com as evidências científicas que as apoiam. Os aspectos gerais da literatura existente e as intervenções preconcebidas recomendadas são descritas, juntamente com a qualidade das evidências científicas e a força das recomendações por trás de cada uma dessas intervençõesCONCLUSÃO: Muitas intervenções clínicas foram identificadas que poderiam ser oferecidas às mulheres antes da concepção para ajudar a evitar resultados adversos. A maioria dessas intervenções possui evidências científicas para apoiar seu papel na melhoria dos resultados da gravidez. Portanto, recomenda-se que os prestadores de cuidados clínicos incorporem serviços de preconcepção baseados em evidências em seus cuidados diários a mulheres em idade reprodutiva, em um esforço para melhorar a saúde das mulheres antes e depois da gravidez. durante a gravidez, bem como melhorar os resultados da gravidez para mulheres e filhos

Preconception care: developing and implementing regional and national programs

INTRODUCTION: During the past few decades, health workers have come to agree that there is a very important place for preconception care (PCC) in improving maternal and infant pregnancy outcomes. The United States Centers for Disease Control and Prevention (CDC) and the World Health Organization issued recommendations encouraging countries to develop and implement preconception care programs. The reports include an in-depth discussion of the rationale and scientific evidence behind PCC as well as definitions, goals, components and recommended interventions to be included in PCC. These reports also offer very broad guidelines but do not offer details on how to develop and implement preconception care programsOBJECTIVE: The CDC and WHO reports identify the need for multi-sectoral engagement in developing and implementing preconception care programs and propose some activities and strategies to be considered in developing PCC programs. However, the recommendations fall short of specifying real steps that countries and regions should take in implementing PCC programs. In this publication we propose action steps for developing and implementing regional or national preconception care programsMETHODS: We reviewed the published and unpublished literature (using PubMed and the Internet) to identify reports that describe processes for developing and implementing PCC programs. We used information from the literature along with experiences we gained through our work and interaction with States and developing countries to prepare a detailed description of the steps involved in developing and implementing a PCC programRESULTS: We found very little in terms of "tools" for program managers and providers to use when developing and implementing PCC programs. We prepared a guide, including a summary of steps and a proposed timeline, for program directors to use for developing and implementing PCC programsCONCLUSION: Developing and implementing a sustainable PCC program should address issues related to educating the public, providers and policy makers about the benefits of PCC. It also includes establishing an infrastructure within the departments of health and ensuring resources to build, guide, monitor and evaluate the PCC program. Finally, implementation of a successful program depends heavily on the proper training of public health and clinical care providers in the delivery of the services included in the program

INTRODUÇÃO: Nas últimas décadas, os profissionais de saúde chegaram a um acordo sobre a importância dos cuidados preconcepção na melhoria dos resultados da gravidez materna e infantil. Os Centros dos Estados Unidos para Controle e Prevenção de Doenças (CDC) e a Organização Mundial da Saúde emitiram recomendações incentivando os países a desenvolver e implementar programas de assistência preconcepção. Os relatórios incluem uma discussão aprofundada da lógica e das evidências científicas por trás do PCC, bem como definições, objetivos, componentes e intervenções recomendadas a serem incluídas no PCC. Esses relatórios também oferecem diretrizes muito amplas, mas não oferecem detalhes sobre como desenvolver e implementar programas de assistência preconcepçãoOBJETIVO: Os relatórios do CDC e da OMS identificam a necessidade de envolvimento multissetorial no desenvolvimento e implementação de programas de assistência pré-conceitual e propõem algumas atividades e estratégias a serem consideradas no desenvolvimento de programas do PCC. No entanto, as recomendações não especificam as medidas reais que os países e regiões devem adotar na implementação de programas de assistência preconcepção. Neste artigo, propomos etapas de ação para o desenvolvimento e implementação de programas regionais ou nacionais de assistência pré-conceitualMÉTODO: Foi revisada a literatura publicada usando o PubMed para identificar relatórios que descrevem processos para o desenvolvimento e implementação de programas de assistência preconcepção. As informações da literatura foram utilizadas, juntamente com as experiências adquiridas por meio de nosso trabalho e interação com os Estados e os países em desenvolvimento, para preparar uma descrição detalhada das etapas envolvidas no desenvolvimento e na implementação de um programa de assistência preconcepçãoRESULTADOS: Pouco foi encontrado em termos de "ferramentas" para os gerentes e provedores de programas usarem ao desenvolver e implementar programas de assistência preconcepção. Este artigo foi preparado como um guia, incluindo um resumo das etapas e um cronograma proposto, para os diretores de programas usarem no desenvolvimento e na implementação de programas de assistência preconcepçãoCONCLUSÃO: O desenvolvimento e implementação de um programa sustentável do PCC deve abordar questões relacionadas à educação do público, fornecedores e formuladores de políticas sobre os benefícios do PCC. Também inclui o estabelecimento de uma infraestrutura nos departamentos de saúde e a garantia de recursos para construir, orientar, monitorar e avaliar o programa PCC. Finalmente, a implementação de um programa bem-sucedido depende muito do treinamento adequado dos prestadores de serviços de saúde pública e atendimento clínico na prestação dos serviços incluídos no programa

Preconception care to improve pregnancy outcomes: clinical practice guidelines

INTRODUCTION: There is scientific evidence that the health of women before pregnancy contributes to the maternal and infant outcomes of pregnancy. There is also scientific evidence that the health of women of reproductive age may be improved through the provision of Preconception Care (PCC). Preconception care includes interventions to assess, identify, address, and modify a woman's health conditions and risks to ensure that these health conditions and risks do not negatively affect the outcome of her pregnancy. Many of the medical conditions, environmental exposures, personal behaviors, and psychosocial risks associated with negative pregnancy outcomes have been identified and there are recommendations for including these conditions in PCC servicesOBJECTIVE: Our purpose is to present a tool for clinical care providers involved in delivering PCC services. We try to answer the following questions: what do providers actually do when a woman of reproductive age arrives at their offices? What questions to ask? What examinations to conduct? What laboratory tests to perform? And, what education and counselling to offer?METHODS: We reviewed published and un-published literature related to the scientific evidence for the effectiveness of PCC in improving pregnancy outcomes. We searched PubMed for published articles, and we searched the internet for unpublished reports prepared by international organizations such as the World Health Organization and reports from governmental agencies. We summarized the information and presented a comprehensive overview of actions that providers should take to address various risk behaviors, exposures and health conditionsRESULTS: Several scientists, countries, and international organizations have proposed answers to the above questions. However, there has been no consistency and there is not a single publication that includes a comprehensive compilation of the proposed actions. We summarized the recommended actions that clinical care providers should take in addressing various health conditions, risk behaviors, and exposuresCONCLUSION: It is recommended that all providers screen all women for their intentions to become pregnant and to provide them with appropriate services. Women should be referred to specialized care when risk behaviors and medical conditions that go beyond the skills and abilities of the primary care provider are identified

INTRODUÇÃO: Existem evidências científicas de que a saúde das mulheres antes da gravidez contribui para os resultados maternos e infantis da gravidez. Há também evidências científicas de que a saúde das mulheres em idade reprodutiva pode ser melhorada através da prestação de cuidados preconcepção. Os cuidados preconcepção incluem intervenções para avaliar, identificar, abordar e modificar as condições e riscos de saúde de uma mulher para garantir que essas condições e riscos não afetem negativamente o resultado de sua gravidez. Muitas condições médicas, exposições ambientais, comportamentos pessoais e riscos psicossociais associados a resultados negativos da gravidez foram identificados e existem recomendações para a inclusão dessas condições nos serviços de assistência preconcepçãoOBJETIVO: O objetivo deste estudo é servir como uma ferramenta para os prestadores de cuidados clínicos envolvidos na prestação de serviços de cuidados preconcepção. Tentamos responder às seguintes perguntas: o que os profissionais realmente fazem quando uma mulher em idade reprodutiva chega a seus escritórios? Que perguntas fazer? Quais exames realizar? Quais exames laboratoriais devem ser realizados? E que educação e aconselhamento oferecer?MÉTODO: Revisamos a literatura publicada e não publicada relacionada à evidência científica para a eficácia dos cuidados preconcepção na melhoria dos resultados da gravidez. Pesquisamos no PubMed por artigos publicados e pesquisamos na Internet relatórios não publicados preparados por organizações internacionais como a Organização Mundial da Saúde e relatórios de agências governamentais. Resumimos as informações e apresentamos uma visão abrangente das ações que os fornecedores devem adotar para abordar vários comportamentos de risco, exposições e condições de saúdeRESULTADOS: Vários cientistas, países e organizações internacionais propuseram respostas para as perguntas acima. No entanto, não houve consistência e não há uma única publicação que inclua uma compilação abrangente das ações propostas. Resumimos as ações recomendadas que os prestadores de cuidados clínicos devem adotar para lidar com várias condições de saúde, comportamentos de risco e exposiçõesCONCLUSÃO: Recomenda-se que todos os profissionais examinem todas as mulheres quanto à sua intenção de engravidar e forneçam-lhes os serviços adequados. As mulheres devem ser encaminhadas para atendimento especializado quando forem identificados comportamentos de risco e condições médicas que vão além das habilidades do prestador de cuidados primários

Comportamiento clínico epidemiológico de gestantes adolescentes con hipertensión arterial / Clinical epidemiological behavior of adolescent pregnant women with arterial hypertension

RESUMEN Fundamento: los trastornos hipertensivos son considerados como la principal causa de morbimortalidad materna y fetal a nivel mundial y en Ecuador. Objetivo: describir el comportamiento clínico epidemiológico de los trastornos hipertensivos de la gestación en adolescentes. Métodos: se realizó un estudio descriptivo que incluyó las 59 de gestantes adolescentes que presentaron preeclampsia o eclampsias atendidas en el contexto de la investigación durante el periodo comprendido entre mayo y diciembre de 2017. Se aplicó un cuestionario de investigación para obtener la información relacionada con las variables de investigación definidas. Resultados: promedio de edad de 16,32 años, predominio de gestantes con color de la piel no blanco y nulíparas. Elevado número de comorbilidades asociadas con predominio del sobrepeso e hipertensión arterial; predominio de pacientes que no habían recibido tratamiento preventivo con calcio y aspirina. La cefalea y el edema en miembros inferiores fueron las complicaciones maternas más frecuentes. El sufrimiento fetal, el crecimiento intrauterino retardado y la prematuridad fueron las complicaciones fetales con mayor frecuencia de presentación. Conclusiones: el patrón clínico y epidemiológico de las adolescentes con preeclampsia y eclampsia coincide con lo reportado en la literatura universal. Se evidencian falencias en el programa de control de riesgo preconcepcional y en la calidad del seguimiento de las gestantes que motiva un aumento de la incidencia de eclampsia y preeclampsia.

ABSTRACT Background: hypertensive disorders are considered as the main cause of maternal and fetal morbidity and mortality worldwide and in Ecuador. Objective: to describe the epidemiological clinical behavior of hypertensive disorders of pregnancy in adolescents. Methods: a descriptive study was carried out which included the 59 of pregnant teenagers who presented preeclampsia and/or eclampsia attended in the context of the research during the period from May to December 2017. A research questionnaire was applied to obtain information related to the variables of defined research. Results: average age of 16.32 years, predominance of pregnant women with non-white skin color and nulliparous. High number of comorbidities associated with a predominance of overweight and arterial hypertension; predominance of patients who had not received preventive treatment with calcium and aspirin. Headache and edema in the lower limbs were the most frequent maternal complications. Fetal distress, delayed intrauterine growth and prematurity were the fetal complications with the highest frequency of presentation. Conclusions: the clinical and epidemiological pattern of adolescents with preeclampsia and eclampsia coincides with that reported in the universal literature. Failures are evident in the preconception risk control program and in the quality of the follow-up of pregnant women that motivates an increase in the incidence of eclampsia and preeclampsia.

Advances in clinical management of pregnant women with preexisting diabetes / 中华围产医学杂志

Pregnant women with preexisting diabetes have increased adverse maternal and neonatal outcomes.Preconception planning is necessary for avoiding unintended pregnancies and mitigating risk of congenital defects.The recommended glycosylated hemoglobin goals are ＜6.5％ before conception and ＜6.0％ during pregnancy.Screening and management for diabetic complications are critical,strict blood pressure control goal need to be achieved,especially for those complicated by nephropathy.Continuous glucose monitoring during pregnancy might help improve blood glucose control for women with type 1 diabetes.Insulin is still the first-line therapy for pregnant women with preexisting diabetes.Optimization of glycemic control,appropriate medication regimens and close attention to comorbidities can help minimize the matemal and neonatal adverse outcomes and ensure the quality of clinical management for women with preexisting diabetes before,during,and after pregnancy.

Women's preconception health patterns in traditional Chinese medicine as a predictor of fertility outcomes / 中西医结合学报

OBJECTIVE@#To examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes.@*METHODS@#A community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher's exact tests, logistic regression models, general linear models and the Cox proportional hazard model.@*RESULTS@#The fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55-801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90-23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1-3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12-3.25) pattern had a higher risk of spontaneous miscarriage.@*CONCLUSION@#Three unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women's fecundability and birth outcomes.

Caracterización de mujeres con riesgo preconcepcionalen el CMF 24. Policlínico René Vallejo Ortiz / Characterization of women at preconceptional risk in CMF 24. Polyclinic René Vallejo Ortiz / Caracterização de mulheres em risco preconceitual no CMF 24. Policlínica René Vallejo Ortiz

RESUMEN El riesgo reproductivo está condicionado por una serie de factores, enfermedades o circunstancias únicas o asociadas que pueden repercutir desfavorablemente en el binomio, durante el embarazo, parto o puerperio. Se realizó un estudio observacional, longitudinal y retrospectivo; con el objetivo de identificar los factores de riesgo preconcepcional en mujeres del Consultorio Médico de Familia 24, perteneciente al Policlínico René Vallejo Ortiz,de Bayamo, entre enero y diciembre del 2017. Se diseñó un estudio de casos y controles no pareados con relación no enfermo-enfermo (4:1), la muestra estuvo conformada por 128 mujeres sanas y 32 enfermas; los datos se obtuvieron a partir de una planilla de recolección de datos aplicada y su historia clínica. Se aplicó como instrumento epidemiológico para tener una medida que cuantifique las fuerzas de asociación, la razón de productos cruzados y el Chi cuadrado. La edad menor de 18 años, mayor de 35 años y la talla inferior a 150 cm se constituyeron en los antecedentes biológicos asociados con el riesgo preconcepcional. El aborto a repetición fue el antecedente obstétrico asociados con este riesgo. Las afecciones asociadas con el mismo fueron la hipertensión arterial, las cardiopatías y el asma bronquial. El bajo nivel de escolaridad fue el antecedente socio ambiental asociado.

ABSTRACT Reproductive risk is conditioned by a series of unique or associated factors, diseases or circumstances that may have an unfavorable impact on the binomial, during pregnancy, childbirth or the puerperium. An observational, longitudinal and retrospective study was carried out; with the objective of identifying the preconceptional risk factors in women of the Family Medical Office 24, belonging to the René Vallejo Ortiz Polyclinic, from Bayamo, between January and December 2017. A study of unmatched cases and controls with a non-ill relationship was designed. - ill (4: 1), the sample consisted of 128 healthy and 32 sick women; the data were obtained from an applied data collection form and its medical history. It was applied as an epidemiological instrument to have a measure that quantifies the forces of association, the ratio of cross products and Chi square. The age under 18, over 35 years and the size below 150 cm were the biological background associated with the preconception risk. Repeated abortion was the obstetric history associated with this risk. The conditions associated with it were high blood pressure, heart disease and bronchial asthma. The low level of schooling was the associated socio-environmental background.

RESUMO O risco reprodutivo é condicionado por uma série de fatores, doenças ou circunstâncias únicas ou associadas que podem ter um impacto desfavorável no binômio, durante a gravidez, o parto ou o puerpério. Foi realizado um estudo observacional, longitudinal e retrospectivo; com o objetivo de identificar os fatores de risco de preconceito em mulheres do Serviço Médico da Família 24, pertencentes à Policlínica René Vallejo Ortiz, de Bayamo, entre janeiro e dezembro de 2017. Foi realizado um estudo de casos e controles incomparáveis ​​com relação não-doente. - doente (4: 1), a amostra foi composta por 128 mulheres saudáveis ​​e 32 doentes; os dados foram obtidos de um formulário de coleta de dados aplicado e seu histórico médico. Foi aplicado como instrumento epidemiológico a medida que quantifica as forças de associação, a proporção de produtos cruzados e o quadrado do Chi. Idade abaixo de 18 anos, acima de 35 anos e tamanho abaixo de 150 cm foram os antecedentes biológicos associados ao risco de preconceito. O aborto repetido foi a história obstétrica associada a esse risco. As condições associadas a ela foram pressão alta, doenças cardíacas e asma brônquica. O baixo nível de escolaridade foi o background socioambiental associado.

Factores biopsicosociales asociados al riesgo preconcepcional CMF No 9. Campechuela / Biopsychosocial factors associated with preconception risk CMF No 9. Campechuela / Fatores biopsicossociais associados ao risco de preconceito CMF n° 9. Campechuela

RESUMEN Introducción: el riesgo reproductivo preconcepcional (RRPC) se aplica a mujeres en edad reproductiva no embarazadas, que según el riesgo tienen posibilidad de sufrir daños a su salud o la del futuro hijo si se involucraran en el proceso reproductivo. Se realizó un estudio descriptivo de corte transversal sobre los factores biopsicosociales asociados al riesgo reproductivo preconcepcional. Objetivo: determinar los factores biopsicosociales asociados al riesgo reproductivo preconcepcional en el CMF No 9 en el Policlínico Gustavo Aldereguía Lima, en el periodo octubre 2016-abril 2018. Método: se realizó un estudio descriptivo con pacientes dispensarizadas y evaluadas como riesgo preconcepcional en el Consultorio Médico de la Familia No 9 perteneciente al Policlínico Gustavo Aldereguía Lima. Campechuela. Octubre 2016- abril 2018. La muestra de estudio seleccionada de forma intencional estuvo constituida por 80 mujeres dispensarizadas de riego preconcepcional y que cumplieron con los criterios de inclusión y de exclusión. Se utilizaron variables como edad, nivel escolar, ocupación, estado civil, tipo de anticoncepción que utilizaban, afecciones biológicas y antecedentes obstétricos desfavorables. Para obtener la información se utilizó una encuesta la cual se procesó de forma computarizada, mostrando los resultados mediante tablas. Resultados: predominaron las pacientes con edades menores de 20 años, con un nivel de escolaridad de pre universitario sin concluir, amas de casa, solteras, siendo el preservativo el anticonceptivo más utilizado. El asma bronquial fue la afección más diagnosticada, la HTA gravídica el antecedente obstétrico desfavorable que predominó y desconocimiento general del Programa para el Control de Riesgo Preconcepcional. A partir del resultado obtenido se elaboró un sistema de actividades educativas sustentadas en la educación para la salud. Conclusiones: trabajar intencionadamente desde la promoción y la prevención en aspectos de riesgo preconcepcional en la adolescencia, intensificando la prevención del embarazo en esta edad vulnerable. Intensificar la prevención de las enfermedades crónicas desde edades tempranas.

ABSTRACT Introduction: the preconception reproductive risk (RRPC) applies to women of non-pregnant reproductive age, who according to the risk have the possibility of suffering damage to their health or that of the future child if they are involved in the reproductive process. A descriptive cross-sectional study was conducted on the biopsychosocial factors associated with preconception reproductive risk. Objective: to determine the biopsychosocial factors associated with preconception reproductive risk in CMF No 9 at the Gustavo Aldereguía Lima Polyclinic, in the period October 2016-April 2018. Method: a descriptive study was conducted with patients dispensed and evaluated as preconception risk in the Family Medical Office No. 9 belonging to the Gustavo Aldereguía Lima Polyclinic. Campechuela October 2016- April 2018. The intentionally selected study sample consisted of 80 women dispensed with preconception irrigation and who met the inclusion and exclusion criteria. Variables such as age, school level, occupation, marital status, type of contraception used, biological conditions and unfavorable obstetric history were used. To obtain the information, a survey was used which was processed in a computerized way, showing the results through tables. Results: patients under 20 years of age predominated, with an unfinished level of pre-university education, housewives, single women, the condom being the most commonly used contraceptive. Bronchial asthma was the most diagnosed condition, gravitational AHT, the predominant unfavorable obstetric history and general ignorance of the Preconception Risk Control Program. From the result obtained, a system of educational activities based on health education was developed. Conclusions: to work intentionally from the promotion and prevention in aspects of preconception risk in adolescence, intensifying the prevention of pregnancy in this vulnerable age. Intensify the prevention of chronic diseases from an early age.

RESUMO Introdução: o risco reprodutivo preconceito (RRPC) aplica-se a mulheres em idade reprodutiva não gestantes, que, de acordo com o risco, têm a possibilidade de sofrer danos à sua saúde ou à do futuro filho se estiverem envolvidas no processo reprodutivo. Foi realizado um estudo descritivo de corte transversal sobre os fatores biopsicossociais associados ao risco reprodutivo pré-concepção. Objetivo: determinar os fatores biopsicossociais associados ao risco reprodutivo pré-conceitual no CMF n.o 9 da Policlínica Gustavo Aldereguía Lima, no período de outubro de 2016 a abril de 2018. Método: foi realizado um estudo descritivo com pacientes dispensados ​​e avaliados como risco de preconceito no Serviço Médico da Família nº 9 pertencente à Policlínica Gustavo Aldereguía Lima. Campechuela Outubro de 2016 a abril de 2018. A amostra selecionada intencionalmente foi composta por 80 mulheres dispensadas de irrigação por preconceito e que preencheram os critérios de inclusão e exclusão. Foram utilizadas variáveis ​​como idade, escolaridade, ocupação, estado civil, tipo de contracepção utilizado, condições biológicas e história obstétrica desfavorável. Para obter as informações, utilizou-se uma pesquisa que foi processada de forma computadorizada, mostrando os resultados através de tabelas. Resultados: predominaram pacientes com menos de 20 anos de idade, com nível de educação pré-universitário inacabado, donas de casa, mulheres solteiras, sendo o preservativo o contraceptivo mais utilizado. A asma brônquica foi a condição mais diagnosticada, a AHT gravitacional, a história obstétrica desfavorável predominante e o desconhecimento geral do Programa de Controle de Risco de Preconceito. A partir do resultado obtido, foi desenvolvido um sistema de atividades educativas baseadas na educação em saúde. Conclusões: trabalhar intencionalmente a partir da promoção e prevenção em aspectos de risco de preconceito na adolescência, intensificando a prevenção da gravidez nessa idade vulnerável. Intensificar a prevenção de doenças crônicas desde tenra idade.

Factores de riesgo asociados al riesgo reproductivo preconcepcional. Niquero. Granma / Risk factors associated with preconceptional reproductive risk. Niquero. Granma / Fatores de risco associados ao risco reprodutivo pré-concepção. Níquero. Granma

RESUMEN Introducción: el riesgo reproductivo es la probabilidad que tiene una mujer o su producto, de sufrir daño, lesión o muerte durante el proceso de la reproducción. Se aplica a mujeres en edad reproductiva, entre 15 y 49 años. Objetivo: identificar los factores biosipcosociales asociados al riesgo reproductivo preconcepcional en el consultorio 18 de Niquero en el período de Septiembre 2018 a Febrero 2019. Método: se realizó un estudio descriptivo de corte transversal con una muestra de 126 mujeres dispenzarisadas como riesgo preconcepcional, escogida de manera intencional. La obtención de la información se realizó a través la encuesta y de las historias clínicas individuales de las pacientes. Los datos se procesaron en números y porciento. Resultados: predominaron las mujeres menores de 20 años, alta presencia de hábitos tóxicos siendo el consumo del café el más frecuente, los antecedentes patológicos personales más referidos fueron el asma bronquial seguida de la hipertensión arterial y dentro de los antecedentes obstétricos desfavorables la hipertensión arterial gravídica y el bajo peso al nacer constituyeron los más frecuentes. Conclusiones: se lograron identificar los riesgos más frecuentes asociados al riesgo reproductivo preconcepcional, lo que permitirá trazar estrategias de salud para lograr disminuir la morbimortalidad materno infantil.

ABSTRACT Introduction: the reproductive risk is the probability that a woman or her product has, of suffering damage, injury or death during the process of reproduction. It applies to women of reproductive age, between 15 and 49 years. Objective: to identify the biosipcosocial factors associated with preconceptional reproductive risk in the Niquero 18 office during the period from September 2018 to February 2019. Method: a descriptive cross-sectional study was carried out with a sample of 126 dispenzarisadas women as a preconceptional risk, chosen intentionally. The information was obtained through the survey and the individual medical records of the patients. The data was processed in numbers and percent. Results: predominantly women under 20 years, high presence of toxic habits with coffee consumption being the most frequent, the personal pathological background most referred were bronchial asthma followed by arterial hypertension and within the unfavorable obstetric history gravidarum hypertension and low birth weight constituted the most frequent. Conclusions: the most frequent risks associated with preconceptional reproductive risk were identified, which will allow us to draw up health strategies to reduce maternal and infant morbidity and mortality.

RESUMO Introdução: o risco reprodutivo é a probabilidade de uma mulher ou seu produto sofrer danos, ferimentos ou morte durante o processo de reprodução. Aplica-se a mulheres em idade reprodutiva, entre 15 e 49 anos. Objetivo: identificar os fatores biossocossociais associados ao risco reprodutivo pré-conceitual no escritório de Niquero 18 no período de setembro de 2018 a fevereiro de 2019. Método: foi realizado um estudo descritivo transversal com amostra de 126 mulheres dispersas como risco de preconceito, escolhidas intencionalmente. As informações foram obtidas por meio da pesquisa e dos prontuários individuais dos pacientes. Os dados foram processados em números e por cento. Resultados: predominaram mulheres com menos de 20 anos de idade, alta presença de hábitos tóxicos, sendo o consumo de café o mais frequente, a história patológica pessoal mais referida foi asma brônquica seguida de hipertensão arterial e, dentro da história obstétrica desfavorável, hipertensão gravídica e baixo peso ao nascer foram os mais frequentes. Conclusões: foi possível identificar os riscos mais frequentes associados ao risco reprodutivo preconceito, o que permitirá o desenvolvimento de estratégias de saúde para reduzir a morbimortalidade materna e infantil.

Jacinto Lang y la atención preconcepcional a la mujer con diabetes mellitus en Cuba / Jacinto Lang and preconception care for women with diabetes mellitus in Cuba

RESUMEN El doctor Jacinto Lang Prieto fue uno de los pioneros de la atención preconcepcional a la mujer con diabetes en Cuba, la cual inició a principios de la década de los años 90 del siglo pasado en el Centro de Atención al Diabético del Instituto Nacional de Endocrinología. Junto a su tutor, el Dr. Antonio Márquez Guillén, creó en esta institución una consulta con la finalidad de ofrecer este tipo de atención. Gracias a la labor de estos galenos comenzó, en 2007, la expansión de la atención preconcepcional a todo el país y en 2012, esta actividad estaba establecida a nivel nacional. En el presente, la atención preconcepcional forma parte de la atención al riesgo reproductivo de la mujer con diabetes, labor en la que deben desempeñar un papel preponderante los profesionales de la atención primaria de salud. Lograr la mejoría de este aspecto de la actividad nacional de diabetes y embarazo constituye uno de los retos actuales en este campo en Cuba(AU)

ABSTRACT Dr. Jacinto Lang Prieto was one of the pioneers of preconception care for women suffering from diabetes in Cuba, which began in the early 1990s at the Center for Diabetic Care of the National Institute of Endocrinology. Together with his tutor, Dr. Antonio Márquez Guillén, he created a consultation at this institution in order to offer this care. Thanks to the work of these doctors, in 2007, the expansion of preconceptional care throughout the country began and this activity was established nationwide in 2012. At present, preconception care is part of the risk management to the diabetes reproductive women. Primary health care professionals should play a leading role in providing this care. Improving preconceptional care for diabetes women as part of national strategy of is one of the current challenges in this field in Cuba(AU)

Increasing the chances of natural conception: opinion statement from the the brazilian federation of gynecology and obstetrics associations - FEBRASGO committee of gynecological endocrinology / Aumentando as chances de concepção natural: parecer da comissão nacional de ginecologia endócrina da Federação Brasileira das Associações de Ginecologia e Obstetrícia

Abstract Considering that myths and misconceptions regarding natural procreation spread rapidly in the era of easy access to information and to social networks, adequate counseling about natural fertility and spontaneous conception should be encouraged in any kind of health assistance. Despite the fact that there is no strong-powered evidence about any of the aspects related to natural fertility, literature on how to increase the chances of a spontaneous pregnancy is available. In the present article, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO, in the Portuguese acronym) Committee on Endocrine Gynecology provides suggestions to optimize counseling for non-infertile people attempting spontaneous conception.

Resumo Uma vez que mitos e equívocos sobre a procriação natural se espalham rapidamente na era do fácil acesso à informação e às redes sociais, o aconselhamento adequado sobre a fertilidade natural e a concepção espontânea deve ser encorajado em qualquer tipo de assistência à saúde. Apesar do fato de não haver evidências fortes sobre qualquer dos aspectos relacionados à fertilidade natural, existe literatura sobre como aumentar as chances de uma gravidez espontânea. No presente artigo, a Comissão Nacional de Ginecologia Endócrina da Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO) oferece sugestões para otimizar o aconselhamento a pessoas que tentam a concepção espontânea, na ausência do diagnóstico de infertilidade.

Development of Preconception Health Behavior Scale / 여성건강간호학회지

PURPOSE: This study was designed to develop a valid and reliable scale for the evaluation of preconception health behavior in women preparing for pregnancy. METHODS: The initial strategy included a literature review, interviews, and construction of a conceptual framework. The preliminary items were evaluated twice for content validity by experts, and modified two preliminary investigations. Participants in the 2 main investigations and the confirmation investigation were tested for reliability and validity of the preliminary scale in women preparing for pregnancy. The data were analyzed for different items exploratory and confirmatory factors. RESULTS: The 5-point Likert scale consisted of 6 factors and 27 items. The 6-factors included ‘hazardous substance factor,’ ‘medical management factor,’ ‘rest and sleep factor,’ ‘stress management factor,’ ‘information acquisition factor,’ and ‘resource preparation factor.’ Goodness of fit of the final research model was very appropriate and based on the following measures: Q=1.98, comparative fit index=.91, Tucker-lewis index=.89, standardized root mean square residual=.07, and root mean square error of approximation=.07. The criterion validity was .64. The reliability coefficient was .92 and the test-retest reliability was .61. CONCLUSION: The study findings indicate that the scale can be used for the development of nursing interventions to promote preconception health behavior in women preparing for pregnancy.

Transnational preconception cohort studies: a review / 中华围产医学杂志

Preconception cohort studies allow us to conduct in-depth investigations on exposures and heath related factors of couples before pregnancy, and to explore the impact on reproductive health of the couples and on short- and long-term health of the offspring. As a critical window into early life, this area has been gradually gaining much attention worldwide. This paper summarized the characteristics of 21 transnational preconception cohort studies with large samples size, to provide information for relevant researchers in China. Emphasis on international cooperation, application of highly efficient data systems or research tools, and long-term longitudinal survey on parents and their offspring are the direction of further preconception cohort researches.