#174 : Preconception Risk Factors and Interventions to Prevent Adverse Maternal, Perinatal, and Child Health Outcomes

Abstract

Background and Aims: Preconception period allows to explore and intervene how women’s health conditions and certain risk factors could affect the mother and newborn’s health, once she becomes pregnant. Limited studies have been conducted on adolescents and young adults, and relatively little is known about the factors underlying the continued increase in the adverse outcomes. Thus, we aimed to identify existing evidence on preconception risk factors and interventions to improve the health of adolescents, young adults, and their children. Method: We conducted a scoping review following the 2020 PRISMA guidelines by systemically populating the searches identified from online databases such as Medline, Embase, Cochrane Library etc. We included studies looking at preconception risk factors and interventions among adolescents and young adults and their impact on perinatal, maternal, and child outcomes. We included systematic and scoping reviews and overview of reviews published in the last 10 years. Two review authors independently evaluated and screened studies for eligibility and extracted data on Covidence software; followed by a descriptive and thematic analysis. Results: The study identified several preconception risk factors such as malnutrition, teen-pregnancy, substance abuse, violence, infections, poor oral health, and chronic diseases. Preconception risk factors contributed to high risk of preterm birth, pre-eclampsia, gestational diabetes, congenital malformation, and neural tube or congenital heart defect. Interventions such as women empowerment, psychological counselling, food fortification; integration of nutrition initiatives, nutritional supplementation, preconception management of epilepsy, and phenylketonuria, pre-pregnancy diabetic care have contributed to improving these outcomes. Conclusion: The findings of the study helped in identifying existing interventions and its impact on perinatal, maternal, and child outcomes. It highlighted the research gaps on preconception risk factors and interventions in different contexts and geographical settings. It suggests prioritisation of future research by development of strategies to improve preconception health at adolescence.