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Preconception health

Catriona Mill, Joanne Enders, Cynthia Montanaro, Kieran Michael Moore
The trend toward delayed parenthood is on the rise across Canada. Societal emphasis on attaining higher education, career advancement and financial security may be some reasons why individuals delay becoming a parent; whatever the reason, this trend is linked to significant health and economic impacts. Many Canadians are unaware of the impact this may have on their fertility and potential birth outcomes. It is important that health care professionals apprise individuals in their reproductive years about these issues and the steps they can take to mitigate these risks...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Cristina R Lammers, Polly A Hulme, Howard Wey, Jennifer Kerkvliet, Shivaram P Arunachalam
Despite evidence of the benefits of preconception health care (PCHC), little is known about awareness and access to PCHC for rural, reproductive-aged women. This study aimed to assess the prevalence of PCHC conversations between rural reproductive-age women and health care providers, PCHC interventions received in the past year, and ascertain predictors of PCHC conversations and interventions. Women (n = 868; 18-45 years) completed a questionnaire including reproductive history, health care services utilization, and interest in PCHC...
October 18, 2016: Journal of Community Health
Joel B Krier, Sarah S Kalia, Robert C Green
The development of massively parallel sequencing (or next-generation sequencing) has facilitated a rapid implementation of genomic sequencing in clinical medicine. Genomic sequencing (GS) is now an essential tool for evaluating rare disorders, identifying therapeutic targets in neoplasms, and screening for prenatal aneuploidy. Emerging applications, such as GS for preconception carrier screening and predisposition screening in healthy individuals, are being explored in research settings and utilized by members of the public eager to incorporate genomic information into their health management...
September 2016: Dialogues in Clinical Neuroscience
Briony Hill, Skye McPhie, Lisa J Moran, Paul Harrison, Terry T-K Huang, Helena Teede, Helen Skouteris
Maternal obesity and excessive gestational weight gain (GWG) are significant contributors to the global obesity epidemic. However, isolated lifestyle interventions to address this in pregnancy appear to have only modest benefit and responses can be variable. This paper aims to address the question of why the success of lifestyle interventions to prevent excessive GWG is suboptimal and variable. We suggest that there are inherent barriers to lifestyle change within pregnancy as a life stage, including the short window available for habit formation; the choice for women not to prioritise their weight; competing demands including physiological, financial, relationship, and social situations; and lack of self-efficacy among healthcare professionals on this topic...
September 28, 2016: Midwifery
Franca Marangoni, Irene Cetin, Elvira Verduci, Giuseppe Canzone, Marcello Giovannini, Paolo Scollo, Giovanni Corsello, Andrea Poli
The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population...
October 14, 2016: Nutrients
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique H Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes prior to pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes in the U.S. are lacking. OBJECTIVE: To estimate changes in the prevalence of overall pregestational diabetes (all types) and pregestational type 1 and type 2 diabetes, and whether changes varied by race-ethnicity between 1996 and 2014. STUDY DESIGN: Cohort study conducted among 655,428 pregnancies at a Northern California integrated health delivery system in 1996-2014...
October 14, 2016: American Journal of Obstetrics and Gynecology
Nancy Baugh, David E Harris, AbouEl-Makarim Aboueissa, Cheryl Sarton, Erika Lichter
The objective of this study is to understand the relationships between prepregnancy obesity and excessive gestational weight gain (GWG) and adverse maternal and fetal outcomes. Pregnancy risk assessment monitoring system (PRAMS) data from Maine for 2000-2010 were used to determine associations between demographic, socioeconomic, and health behavioral variables and maternal and infant outcomes. Multivariate logistic regression analysis was performed on the independent variables of age, race, smoking, previous live births, marital status, education, BMI, income, rurality, alcohol use, and GWG...
2016: Journal of Pregnancy
Lucilla Poston, Rishi Caleyachetty, Sven Cnattingius, Camila Corvalán, Ricardo Uauy, Sharron Herring, Matthew W Gillman
Obesity in women of reproductive age is increasing in prevelance worldwide. Obesity reduces fertility and increases time taken to conceive, and obesity-related comorbidities (such as type 2 diabetes and chronic hypertension) heighten the risk of adverse outcomes for mother and child if the woman becomes pregnant. Pregnant women who are obese are more likely to have early pregnancy loss, and have increased risk of congenital fetal malformations, delivery of large for gestational age infants, shoulder dystocia, spontaneous and medically indicated premature birth, and stillbirth...
October 10, 2016: Lancet Diabetes & Endocrinology
Mark Hanson, Mary Barker, Jodie M Dodd, Shiriki Kumanyika, Shane Norris, Eric Steegers, Judith Stephenson, Shakila Thangaratinam, Huixia Yang
Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception...
October 10, 2016: Lancet Diabetes & Endocrinology
Donald K Hayes, Candice R Calhoun, Lin Joseph, JoAnn Y Farnsworth, Kimberly B Arakaki
The Hawai'i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai'i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed...
October 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Susan M Sereika, Dorothy Becker, Patricia Schmitt, A Blair Powell, Ana Maria Diaz, Andrea F R Fischl, Jennifer Thurheimer-Cacciotti, William H Herman, Denise Charron-Prochownik
OBJECTIVE: Because unplanned pregnancies could cause maternal-fetal complications for women with diabetes, family planning vigilance (FPV) is imperative. The aims of this article are to operationalize and describe FPV and examine the associations among FPV behaviors and diabetes self-care management (DSM) and health outcomes of women with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS: Retrospective data were used from a follow-up study of adult women with T1D who participated as adolescents in a preconception counseling (PC) intervention trial and matched comparison women with T1D who did not receive the adolescent PC intervention...
October 11, 2016: Diabetes Care
Hsin-Hsu Chou, Meng-Jiun Chiou, Fu-Wen Liang, Lea-Hua Chen, Tsung-Hsueh Lu, Chung-Yi Li
BACKGROUND: Information about known risk factors for congenital heart disease is scarce. In this population-based study, we aimed to investigate the relation between maternal chronic disease and congenital heart disease in offspring. METHODS: The study cohort consisted of 1 387 650 live births from 2004 to 2010. We identified chronic disease in mothers and mild and severe forms of congenital heart disease in their offspring from Taiwan's National Health Insurance medical claims...
October 11, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Vicki Flenady, Aleena M Wojcieszek, Ingvild Fjeldheim, Ingrid K Friberg, Victoria Nankabirwa, Jagrati V Jani, Sonja Myhre, Philippa Middleton, Caroline Crowther, David Ellwood, David Tudehope, Robert Pattinson, Jacqueline Ho, Jiji Matthews, Aurora Bermudez Ortega, Mahima Venkateswaran, Doris Chou, Lale Say, Garret Mehl, J Frederik Frøen
BACKGROUND: Electronic health registries - eRegistries - can systematically collect relevant information at the point of care for reproductive, maternal, newborn and child health (RMNCH). However, a suite of process and outcome indicators is needed for RMNCH to monitor care and to ensure comparability between settings. Here we report on the assessment of current global indicators and the development of a suite of indicators for the WHO Essential Interventions for use at various levels of health care systems nationally and globally...
September 30, 2016: BMC Pregnancy and Childbirth
Ramona Alfaro Arenas, Jordi Rosell Andreo, Damián Heine Suñer
We report herein results of a study performed in the Balearic Islands which had the following goals: 1) Determine the proportion of pregnant or non-pregnant women planning pregnancy, who would choose to undergo a screening test for Fragile X Syndrome (FXS), if it is accompanied by the appropriate information; 2) Assess satisfaction and any increase in stress among women who participate in screening; 3) Collect epidemiological information about the incidence of the disease in our population; and 4) Collect demographic and health history data and assess participants' awareness of the disease...
October 7, 2016: Journal of Genetic Counseling
Jessica Anne Devido, Susan M Sereika, Susan Merle Cohen, Denise Charron-Prochownik
PURPOSE: The purpose of this study was to examine the relationship between selected internal and external characteristics and communication (intended and actual) with health care providers (HCPs) about reproductive health and preconception counseling among adolescent females with diabetes. METHODS: A descriptive, correlational design was employed to conduct a secondary analysis of baseline data from a multisite, randomized controlled trial. Participants were 110 female adolescents (92% type 1 diabetes)...
September 28, 2016: Diabetes Educator
William M Callaghan, Marian F Macdorman, Carrie K Shapiro-Mendoza, Wanda D Barfield
BACKGROUND: The U.S. infant mortality rate has been steadily decreasing in recent years as has the preterm birth rate; preterm birth is a major factor associated with death during the first year of life. The degree to which changes in gestational age-specific mortality and changes in the distribution of births by gestational age have contributed to the decrease in the infant mortality rate requires clarification. OBJECTIVES: To better understand the major contributors to the 2007-2013 infant mortality decline for the total population, and for infants born to non-Hispanic black, non-Hispanic white, and Hispanic women...
September 26, 2016: American Journal of Obstetrics and Gynecology
Lin Foo, Jerome Cornette, Jasmine Tay, Christoph Lees
INTRODUCTION: There are multiple modalities used to measure cardiac output in pregnancy. The accepted gold standard is cardiac catheterisation, then measurement via direct Fick method or thermo-dilution. These methods are invasive and not feasible for assessment of healthy pregnant women. There are several non-invasive devices widely used to measure cardiac output including Innocor, an inert gas re-breathing technique which has been validated against thermodilution [1-3] and direct Fick methods [4,5] for measurement of pulmonary blood flow and thus, cardiac output...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Sanne van der Hout, Kim Ca Holtkamp, Lidewij Henneman, Guido de Wert, Wybo J Dondorp
Expanded universal carrier screening (EUCS) entails a twofold expansion of long-standing (preconception) carrier screening programmes: it not only allows the simultaneous screening of a large list of diseases ('expanded'), but also refers to a pan-ethnic screening offer ('universal'). Advocates mention three main moral advantages of EUCS as compared with traditional (targeted and/or ancestry-based) forms of carrier screening: EUCS will (1) maximise opportunities for autonomous reproductive choice by informing prospective parents about a much wider array of reproductive risks; (2) provide equity of access to carrier testing services; (3) reduce the risk of stigmatisation...
September 28, 2016: European Journal of Human Genetics: EJHG
Vineet V Mishra, Sakshi S Nanda, Kavita Mistry, Sumesh Choudhary, Rohina Aggarwal, Bhumika M Vyas
BACKGROUND: The number of patients undergoing renal transplant are increasing with time. Most of these patients fall in the reproductive age group, who are going to conceive sooner or later. But there are few recipients who either are infertile before transplant or became infertile due to underlying renal pathology responsible for transplantation. OBJECTIVE: To study fertility outcome in female renal transplant recipients. MATERIALS AND METHODS: HASH(0x4885158) STUDY DESIGN: This is a retrospective study conducted at tertiary health center in Ahmedabad, from 2004 to 2014...
October 2016: Journal of Obstetrics and Gynaecology of India
Amie Steel, Jayne Lucke, Rebecca Reid, Jon Adams
BACKGROUND: The value and importance of preconception care (PCC) have been acknowledged by leading health organizations as a vital element within preventive medicine and health promotion for the wider population. The translation of PCC from position statement to relevant service and programme delivery is essential for the benefits of PCC to be realized and relies on insights from health services research. This article aims to review contemporary health services research literature examining women's and health professionals' perceptions and experiences of PCC services...
September 20, 2016: Family Practice
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