The clinical content of preconception care: infectious diseases in preconception care
Received 13 June 2008; accepted 29 August 2008.
A number of infectious diseases should be considered for inclusion as part of clinical preconception care. Those infections strongly recommended for health promotion messages and risk assessment or for the initiation of interventions include Chlamydia infection, syphilis, and HIV. For selected populations, the inclusion of interventions for tuberculosis, gonorrheal infection, and herpes simplex virus are recommended. No clear evidence exists for the specific inclusion in preconception care of hepatitis C, toxoplasmosis, cytomegalovirus, listeriosis, malaria, periodontal disease, and bacterial vaginosis (in those with a previous preterm birth). Some infections that have important consequences during pregnancy, such as bacterial vaginosis (in those with no history of preterm birth), asymptomatic bacteriuria, parvovirus, and group B streptococcus infection, most likely would not be improved through intervention in the preconception time frame.
aDepartment of Obstetrics and Gynecology, Maricopa Medical Center, Phoenix, AZ
bDepartment of Family and Community Medicine, Maricopa Medical Center, Phoenix, AZ
cDepartment of Family Medicine, Boston University Medical Center, Boston MA
dDepartment of Obstetrics and Gynecology, Boston University Medical Center, Boston MA
eDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of Texas-Houston, Houston, TX
fDepartment of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC
gDepartment of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
hCenters for Disease Control, Division of Reproductive Health/NCCDPHP, Atlanta, GA
iDepartment of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA
jDepartment of Obstetrics & Gynecology, The Ohio State University, Columbus, OH
kDepartments of Obstetrics & Gynecology and Community Health Sciences, UCLA Schools of Medicine & Public Health, Los Angeles CA
lDepartment of Women's Health, Kaiser Permanente, Roseville, CA
mDepartment of Obstetrics and Gynecology, University of Colorado Health Sciences Center. Denver, CO
Reprints: Dean V Coonrod, MD, MPH, Chair, Department of Obstetrics and Gynecology, Maricopa Medical Center, OBGYN Dept, 2nd Floor Admin, 2601 E Roosevelt St, Phoenix, AZ 85008
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Conflict of Interest: Dean V. Coonrod, MD, MPH, is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic. He has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care and funding from Cellestis Inc (Valencia, CA) to study Quantiferon Gold in pregnancy. Brian W. Jack, MD; Phillip G. Stubblefield, MD; Lisa M. Hollier, MD, MPH; Kim A. Boggess, MD; Robert Cefalo, MD, PhD; Shanna N. Cox, MSPH; Anne L. Dunlop, MD, MPH; Kam D. Hunter, MD, PhD; Michael C. Lu, MD, MS, MPH; Jeanne A. Conry, MD, PhD; Ronald S. Gibbs, MD; and Vijaya K. Hogan, DrPH have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Mona R. Prasad, DO, MPH is the recipient of a $25,000 service grant from the March of Dimes for the year 2008.
ABSTRACT