Preconception Interventions with Evidence for Improving Pregnancy Outcomes
| Intervention | Proven Health Effect |
|---|---|
| Folic acid supplementation | Reduces occurrence of neural tube defects by two thirds. |
| Rubella vaccination | Provides protection against congenital rubella syndrome. |
| Diabetes management | Substantially reduces the 3-fold increase in birth defects among infants of diabetic women. |
| Hypothyroidism management | Adjusting levothyroxine dosage early in pregnancy protects proper neurologic development. |
| Hepatitis B vaccination for at risk women | Prevents transmission of infection to the infant and eliminates the risk to the woman of hepatic failure, liver carcinoma, cirrhosis, and death due to HBV infection. |
| HIV/AIDS screening and treatment | Allows for timely treatment and provides women (or couples) with additional information that can influence the timing of pregnancy and treatment. |
| STD screening and treatment | Reduces the risk of ectopic pregnancy, infertility, and chronic pelvic pain associated with Chlamydia trachomatis and Neisseria gonorrhoea and reduces the possible risk to the fetus of fetal death and physical and developmental disabilities, including mental retardation and blindness. |
| Maternal PKU management | Prevents babies from being born with PKU-related mental retardation. |
| Oral anticoagulant use management | Switching women off teratogenic anticoagulants (ie, warfarin) before pregnancy avoids harmful exposure. |
| Antiepileptic drug use management | Changing to a less teratogenic treatment regimen reduced harmful exposure. |
| Accutane use management | Preventing pregnancy for women who use isotretinoin (Accutane) or ceasing isotretinoin use before conception, eliminates harmful exposure. |
| Smoking cessation counseling | Completing smoking cessation before pregnancy care can prevent smoking-associated preterm birth, low birth weight, or other adverse perinatal outcomes. |
| Eliminating alcohol use | Controlling alcohol binge drinking and/or frequent drinking before pregnancy prevents fetal alcohol syndrome and other alcohol-related birth defects. |
| Obesity control | Reaching a healthy weight before pregnancy reduces the risks of neural tube defects, preterm delivery, diabetes, cesarean section, and hypertensive and thromboembolic disease that are associated with obesity. |
PKU, phenylketonuria.