The clinical content of preconception care: women with chronic medical conditions
Received 17 June 2008; accepted 8 August 2008.
This article reviews the medical conditions that are associated with adverse pregnancy outcomes for women and their offspring. We also present the degree to which specific preconception interventions and treatments can impact the effects of the condition on birth outcomes. Because avoiding, delaying, or achieving optimal timing of a pregnancy is often an important component of the preconception care of women with medical conditions, contraceptive considerations particular to the medical conditions are also presented.
aDepartment of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA
bDepartment of Family Medicine, Boston University Medical Center, Boston, MA
cDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine, Stratford, NJ
dDepartment of Obstetrics and Gynecology and Community Health Sciences, University of California, Los Angeles, Schools of Public Medicine and Public Health, Los Angeles, CA
eDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC
fDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH
gBureau of Child and Family Health Services, State of Ohio, Columbus, OH
hDepartment of Obstetrics and Gynecology, Tulane University, New Orleans, LA
iNational Human Genome Project Research Institute, National Institutes of Health, Bethesda, MD
jDepartment of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC
Reprints: Anne Dunlop MD, MPH, Department of Family and Preventive Medicine, Emory University School of Medicine, 1256 Briarcliff Road, Building A, Suite 238, Atlanta, GA 30322
This work was supported in part by the National Human Genome Research Institute, National Institutes of Health.
Conflict of Interest: Anne L. Dunlop, MD, MPH; Brian W. Jack, MD; Michael C. Lu, MD, MS, MPH; Andra James, MD, MPH; Cynthia S. Shellhaas, MD, MPH; Lynne Haygood-Kane Hallstrom, DO, CNM, MS; Benjamin D. Solomon, MD; W. Gregory Feero, MD, PhD; and M. Kathryn Menard, MD, MPH have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Joseph N. Bottalico, DO, is a member of the CDC Select Panel on Preconception Care, a voluntary unpaid position in which he represents the American College of Osteopathic Ob-Gyn and the American Osteopathic Assn (no known conflict). He is also an (appointed, unpaid) volunteer member of the NJ DHSS Diabetes Advisory Council, also without conflict. With the New Jersey Chapter of the March of Dimes, he is a member of the annual conference planning committee (no known conflict) and has received one honorarium from the March of Dimes jointly with the Johnson and Johnson foundation (New Brunswick, NJ) for a grand rounds presentation on preconception care presented to the OB-Gyn Dept at UMDNJ-SOM in December 2007. He sits on the regional MCH consortium's BOD (Southern NJ Perinatal Cooperative) and chairs their Clinical/QA committee which also presents no known conflicts. Mona R. Prasad, DO, MPH is the recipient of a $25,000 service grant from the March of Dimes for the year 2008.
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