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Seo and Kim: Guidelines for preconception care: from the maternal and child health perspectives of Korea
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Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(8): 845-850.

Published online: 9 August 2011

DOI: https://doi.org/10.5124/jkma.2011.54.8.845

Guidelines for preconception care: from the maternal and child health perspectives of Korea

Kyung Seo, MD1, Min-A Kim, MD2

1Department of Obstetrics & Gynecology, Yonsei University College of Medicine, Seoul, Korea.

2Health Promotion Center, Gangnam Severance Hospital, Seoul, Korea.

Corresponding author: Kyung Seo, kyungseo@yuhs.ac

Received 19 April 2011       Accepted 5 May 2011

Copyright © 2011 Korean Medical Association

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Korea has recorded a very low total fertility rate of 1.15 in 2009. Young Koreans tend to postpone their marriage, and as a result of late marriage, the average age of first pregnancy has been continuously increasing. Older married couples often produced multifetal pregnancies due to assisted reproduction. Elderly pregnancies and multifetal pregnancies contribute to high maternal/perinatal mortalities and morbidities. Basic maternal and child health services including prenatal, delivery, and postpartum care are covered under national health insurance in Korea. However, preconception care is not covered under national health insurance nor any other preventive service program. Many developed countries including United States and academic societies have emphasized the importance of preconception care and have proposed guidelines on preconception care. No suggested guidelines for preconception care have been developed in Korea. Evidence-based guidelines on preconception care should be developed with the cooperation of associated academic societies. In addition, the Korean government should develop a comprehensive plan for preventive services for women including preconception care.

Keywords: Preconception care, Guidelines, Preventive health services, Low fertility population, Maternal-child health services

Figures and Tables

Table 1
Recommendations and the quality of the evidence for preconception clinical intervention
jkma-54-845-i001

From Jack BW, et al. Am J Obstet Gynecol 2008;199(6 Suppl 2):S266-S279, with permission from Elsevier [4].

BPA, bisphkenol A.

a) Level A, Recommendations are based on good and consistent scientific evidence; Level B, Recommendations are based on limited or inconsistent scientific evidence; Level C, Recommendations are based primarily on consensus and expert opinion.

b) I, Evidence obtained from at least one properly designed randomized controlled trial (RCT); I-a, Systematic review (with homogeneity) of RCTs and of prospective cohort studies; I-b, Individual RCT with narrow confidence interval, prospective cohort study with; II-1, Evidence obtained from well-designed controlled trials without randomization; II-2, Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group; II-3, Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments also could be regarded as this type of evidence; III, Opinions of respected authorities, based on clinical experience, descriptive stud ies, or reports of expert committees.

References

1. Choi JS, Seo K, Yee NH, Lee SW, Lee SW, Shin CW, Boo YK. Infant and maternal mortality survey in 2007-2008. 2010. Seoul: Ministry for Health, Welfare and Family Affairs, Korea Institute for Health and Social Affairs.
2. Han YJ, Seo K, Lee SW, Hong YJ, Shin SM, Shin CW, Yee NH. Infant mortality and causes of death. 2006. Seoul: Ministry for Health, Welfare and Family Affairs, Korea Institute for Health and Social Affairs.
3. Amercian Academy of Pediatrics. the American College of Obstetricians and Gynecologists. Guideline for perinatal care. 2007. 6th ed. Elk Grove Village (IL): American Academy of Pediatrics.
4. Jack BW, Atrash H, Coonrod DV, Moos MK, O'Donnell J, Johnson K. The clinical content of preconception care: an overview and preparation of this supplement. Am J Obstet Gynecol. 2008. 199:6 Suppl 2. S266–S279.
crossref
5. American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee opinion no. 483: primary and preventive care: periodic assessments. Obstet Gynecol. 2011. 117:1008–1015.
6. Korea Centers for Disease Control and Prevention. Korean Medical Association. Advisory Committee on Immunization Practice. Epidemiology and prevention of vaccine-preventable disease. 2006. Seoul: Korea Centers for Disease Control and Prevention.
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