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Learning Objective 1: The learner will be able to describe a framework for choosing evidence based outcome measures of preconception/interconception care among women of reproductive age.
Learning Objective 2: The learner will be able to state benefits of preconception/interconception care for women of reproductive age.
Problem:
Poor birth outcomes continue to be a problem in the United States despite major advances in medical care. 50% of all pregnancies are unintended and low birth weight, prematurity, small for gestational age, and birth defects account for >10,000 infant deaths per year, representing 35% of all infant deaths. The importance of preconception/interconception care is emphasized in Healthy People 2020 Maternal Infant Child objective #16, however, there is inconsistency with regard to measuring the impact of preconception/interconeption care.
Purpose:
The purpose of this literature review is to develop a framework for choosing evidence-based outcome measures of preconception/interconeption care on women of reproductive age.
Search Strategy:
CINAHL and Medline databases were queried for quantitative articles using the keywords: preconception care, interconception care, interpregnancy intervals and periconceptional. Interventional, retrospective, prospective studies and literature supporting preconception/interconception concepts were included.
Literature Review:
Eight (8) studies were chosen and critiqued for appropriateness of design, logical consistency of the study method, types of validity, statistical significance, sources of error and implications for practice. The articles were also evaluated on whether their research findings supported preconception/interconception care.
Synthesis:
Preconception/interconception care were shown to increase a women’s perceived internal control, awareness of folic acid usage to decrease neural tube defects, improved counseling of pregnant women and facilitation of informed decision making for maternal infections and prepregnancy hyperglycemic control.
Implications for practice:
The studies reviewed support the implementation of preconception/interconception care as an intervention to positively impact the health status of women of reproductive age and health related behaviors influencing birth outcomes such as decreased cigarette smoke and alcohol consumption, increasing folic acid consumption and the proper spacing of pregnancies influence birth outcomes; preterm delivery and low birth weight.
Raishonda Ealy, MSN RN