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JAMA Insights
July 6, 2021

Preconception Care as an Opportunity to Optimize Pregnancy Outcomes

Author Affiliations
  • 1Department of Obstetrics and Gynecology, Washington University in St Louis, St Louis, Missouri
  • 2Department of Obstetrics and Gynecology, The Warren Alpert School of Medicine of Brown University, Providence, Rhode Island
  • 3Women and Infants Hospital of Rhode Island, Providence
JAMA. 2021;326(1):79-80. doi:10.1001/jama.2020.27244

An estimated 74 million women in the United States are of reproductive age (15-44 years).1 Preconception care offers a unique opportunity to address the pressing public health goal of reducing pregnancy-related morbidity and mortality. Preconception counseling identifies modifiable risk factors and providing targeted interventions and education prior to conception. Integration of preconception care into primary medical care and gynecologic care is essential as an estimated 45% of pregnancies in the United States from 2008 through 2011 were unintended.2 According to a report from 2014, individualized preconception counseling well ahead of conception has been associated with improved maternal and neonatal outcomes and can inform personal decisions regarding pregnancy.3 Preconception counseling is particularly important in patients with high-risk conditions that can have substantial effects in the early first trimester before most women initiate prenatal care. For women who choose to defer pregnancy, preconception counseling offers an opportunity to provide contraceptive care.

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