Prematurity and Preconception Care
By Nan Streeter, President, AMCHP
We all know that premature births are on the rise in spite of technological and pharmaceutical advances in the field. We have worked hard to promote the importance of prenatal care to assure healthy outcomes for mothers and their newborns. However, it is clear that prenatal care is too late to prevent poor pregnancy outcomes like prematurity. Instead, we need to redirect our efforts to promote and assure that women of childbearing ages receive preconception health care BEFORE conception.
Preconception health is all about assessing health status and possible risks before pregnancy. Folic acid is an example of preconception health care. Women reduce the risk of their infants having neural tube defects with folic acid intake prior to conception. Preconception health care can be an opportunity to assess possible risks for poor pregnancy outcomes, such as previous pregnancy history, medication, or chronic diseases such as diabetes or heart disease, etc. Some factors that can contribute to a poor pregnancy outcome can be ameliorated to reduce risks, such as change in medication or maintaining good glucose control. With all that we are learning about diabetes, gestational diabetes and the likelihood of developing diabetes later in life, it is clear that diabetes is one example of a chronic disease that can lead to heart defects, prematurity, and so on.
AMCHP has been actively involved in the Preconception Health and Health Care national efforts. Magda Peck, CEO of CityMatCH and I are co chairing the public health workgroup along with the great support of CDC’s Alison Johnson from National Center on Birth Defects and Developmental Disabilities and Sam Posner from the National Center for Chronic Disease Prevention and Health Promotion. AMCHP staff members have participated on the public health workgroup which is addressing data needs, educational needs and integration of preconception health into public health practice. For example, offering preconception health assessment in family planning clinics, well women visits, etc., is an example of integration of services that might not necessarily be offered at the same time.
If you are interested in participating in the national work going on in preconception health and health care, please contact AMCHP for further information.