Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
摘要
Optimising women's pre-pregnancy health is a policy priority for benefits spanning pregnancy and throughout the mother and baby's life. In the UK pre-pregnancy care (PPC) tends to be delivered in primary care, with the onus on women to seek services. We aimed to describe women’s engagement with General Practice (GP) in the year preceding pregnancy, including specific PPC; to explore whether women with recognised risk factors for poor pregnancy outcomes receive targeted care.
MethodsData for women aged 18-48yrs and registered for
Of 193,578 women included, 14,326 had a confirmed pregnancy. 7.6% of the pregnant women had records indicating specific PPC in the preceding year, whilst 41.0% had records of health promotion (advice on nutrition, smoking, weight, alcohol and contraception). More women with pre-existing medical conditions received health promotion (46.0%-83.9% for various risk groups), although the levels of PPC remained low (4.7%-14.9%).
ConclusionsPPC was rarely recorded, likely reflecting low levels of consultation for, or discussion of, pregnancy planning. This represents a missed opportunity for maximising women’s health, particularly in those with recognised risk factors for poor pregnancy, perinatal and longer-term outcomes.