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Cited by 257Maternal and Neonatal HealthcareGlobal Maternal and Child HealthMaternal and Perinatal Health Interventions

Preconception Care for Improving Perinatal Outcomes: The Time to Act

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Atrash, Hani K., Johnson, Kay, Adams, Myron, Cordero, José F., Howse, Jennifer·2006·Maternal and Child Health Journal
DOI 10.1007/s10995-006-0100-4PMC PMC1592246
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Abstract

A healthy baby and a healthy mother are valued hopes and dreams of families of all cultural heritages. National health goals in many countries around the world prioritize infant and maternal mortality and morbidity. In the United States, as in many other industrialized countries, pregnancy outcomes and maternal and infant health indicators have improved dramatically. At the turn of the 20th century, 7.28 women and 96 infants died for every 1,000 babies born alive [ 1 ]. By the end of the year 2000, the maternal mortality rate had decreased to less than 0.08 and infant mortality had decreased to less than 7 deaths per 1,000 live births [ 2 ]. These changes were characterized as one of the ten “great public health achievements” of the 20th century [ 3 ]. Much of this progress can be attributed to changes in social and living conditions as well as the development and implementation of effective medical interventions. Despite this progress, during the last two decades of the 20th century, even in the presence of significant breakthroughs in medical technology and its application, improvements in maternal and infant pregnancy ouctomes slowed down significantly, and in some cases, outcomes deteriorated. For example, from 1960 to 1980, the maternal mortality rate decreased from 32.1 to 9.4 deaths per 100,000 live births, a decrease of 70.7%. From 1980 to 2000, the maternal mortality rate decreased only 12.8%, from 9.4 to 8.2 (Figure 1 ) [ 2 ]. At the same time, from 1980 to 2000, the proportion of babies born preterm, very preterm, low birth weight, and very low birth weight increased by 26%, 8.2%, 14.7% and 25.9%, respectively (Figure 2 ) [ 4 ]. However, unlike other maternal and infant health indicators, from 1980 to 2000 the infant mortality rate continued to decrease almost at a similar pace as that from 1960 to 1980, dropping by 45.2% from 12.6 to 6.9 infant deaths per 1,000 live births, compared with a drop of 51.5% from 26.0 to 12.6 per 1,000 live births for 1960 to 1980 (Figure 1 ) [ 2 ]. Finally, it is estimated that the proportion of babies born in the United States who have a serious or major structural defect that can have adverse effects on their health or development continues to be about 3% [ 5 ].

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  • The prevalence of adverse maternal and neonatal pregnancy outcomes has only moderately decreased over recent decades.

    “Despite major advances in clinical research and medical technology, the prevalence of adverse maternal and neonatal pregnancy outcomes, such as preeclampsia and preterm birth, has only moderately decreased over the recent decades [1].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [1]

    The Introduction (page not specified in our copy) says improvement in U.S. maternal and infant outcomes slowed during 1980–2000, and maternal mortality declined only 12.8%. But it reports that preterm births increased, not decreased, while infant mortality continued to fall substantially; it gives no trend for preeclampsia. The claim captures the broad slowdown but not the trends for its named examples. (LLM, conf=0.88)

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2 of the 105 references couldn’t be matched to a known paper.

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  1. [3]Centers for Disease Control and Prevention Healthier mothers and babies MMWR 1999 48 849 58 Centers for Disease Control and Prevention. Healthier mothers and babies. MMWR 1999;48:849–58. 10563522
  2. [14]March of Dimes Birth Defects Foundation March of Dimes Updates: Is early prenatal care too late? Contemp Ob/Gyn 2002 12 54 72 March of Dimes Birth Defects Foundation. March of Dimes Updates: Is early prenatal care too late? Contemp Ob/Gyn 2002;12:54–72.
  3. [22]Dietary reference intakes for folate and other B vitamins 1998 Washington National Academies Press Institute of Medicine Food and Nutrition Board. Dietary reference intakes for folate and other B vitamins. Washington, DC: National Academies Press; 1998.
  4. [31]Centers for Disease Control and Prevention Strategies for reducing morbidity and mortality from diabetes through health-care system interventions and diabetes self-management education in community settings MMWR 2001 50 RR16 11594724 Centers for Disease Control and Prevention. Strategies for reducing morbidity and mortality from diabetes through health-care system interventions and diabetes self-management education in community settings. MMWR 2001;50(RR16). 11594724
  5. [45]American College of Obstetricians and Gynecologists Preventing deep venous thrombosis and pulmonary embolism Am Fam Physician 2001 63 2279 80 11417780 American College of Obstetricians and Gynecologists. Preventing deep venous thrombosis and pulmonary embolism. Am Fam Physician 2001;63:2279–80. 11417780
  6. [50]Quality Standards Subcommittee of the American Academy of Neurology Practice parameter: management issues for women with epilepsy (summary statement) Neurology 1998 51 944 8 9781510 Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: management issues for women with epilepsy (summary statement). Neurology 1998;51:944–8. 9781510
  7. [67]Subcommittee on nutritional status and weight gain during pregnancy 1990 Washington National Academy Press Institute of Medicine. Subcommittee on nutritional status and weight gain during pregnancy. Washington, DC: National Academy Press; 1990.
  8. [71]Centers for Disease Control and Prevention Gonorrhea—United States, 1998 MMWR 2000 49 538 42 Centers for Disease Control and Prevention. Gonorrhea—United States, 1998. MMWR 2000;49:538–42. 10923855
  9. [87]National Association of State Medicaid Directors. Review of Medicaid Family Planning Expansion Waivers, 2004. Available at: URL: www.nasmd.org.

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Authors
Atrash, H. K., Johnson, K., Adams, M., Cordero, J. F., & Howse, J.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Dartmouth–Hitchcock Medical Center (US)
  • March of Dimes (US)
Corresponding author
Atrash, Hani K.
ORCID
Venue
Maternal and Child Health Journal
Publisher
Springer Science and Business Media LLC
Published
2006-06-14
Volume
10
Issue
S1
Pages
3-11
ISSN
  • 1092-7875 (ISSN-L)
  • 1573-6628
DOI
10.1007/s10995-006-0100-4
PMC
PMC1592246
OpenAlex
W2074096332
Cited by
257
References
105
Citations by year
2026: 2 · 2025: 5 · 2024: 12 · 2023: 14 · 2022: 14 · 2021: 19 · 2020: 22 · 2019: 7 · 2018: 20 · 2017: 15 · 2016: 14 · 2015: 12 · 2014: 16 · 2013: 23 · 2012: 11
FWCI
2.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Maternal and Child Health Journal (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
preconception care, perinatal outcomes, maternal mortality, infant mortality, preterm birth, low birth weight, very low birth weight, maternal health, infant health, pregnancy outcomes, maternal morbidity, health education, prenatal care, quality of care, health care costs
MeSH terms
Diffusion of Innovation, Female, Health Priorities, Humans, Maternal Welfare, Pregnancy, Pregnancy Outcome, Prenatal Care, Risk, Time Factors, Preconception Care

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