School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom.
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Semin Reprod Med. 2022 Jul;40(3-04):170-183. doi: 10.1055/s-0042-1744257. Epub 2022 Jul 13.
Parental health before conception effects maternal and offspring health outcomes. Preconception care provides healthcare to prospective parents addressing modifiable preconception risks and health behaviors. This umbrella review aimed to consolidate evidence on women's and men's modifiable preconception risks or health behaviors associated with maternal and offspring health outcomes. MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, and PsycINFO were searched from March 4, 2010, to March 4, 2020. Eligible studies were systematic reviews or meta-analyses of observational studies examining associations between modifiable preconception risks or health behaviors and maternal and offspring health outcomes. Screening, data extraction, and methodological quality assessment (AMSTAR 2) occurred independently by two reviewers. Degree of overlap was examined. Findings were summarized for evidence synthesis. Twenty-seven systematic reviews were included. Modifiable preconception risks and health behaviors were identified across categories: body composition (e.g., overweight, obesity), lifestyle behaviors (e.g., caffeine, smoking), nutrition (e.g., micronutrients), environmental exposures (e.g., radiation), and birth spacing (e.g., short interpregnancy intervals). Outcomes associated with exposures affected embryo (e.g., embryonic growth), maternal (e.g., gestational diabetes mellitus), fetal/neonate (e.g., preterm birth), and child (e.g., neurocognitive disorders) health. For real-world practice and policy relevance, evidence-based indicators for preconception care should include body composition, lifestyle, nutrition, environmental, and birth spacing.
受孕前父母的健康状况会影响母婴的健康结果。孕前保健为准父母提供医疗服务，解决可改变的孕前风险和健康行为问题。本综述旨在综合有关女性和男性与母婴健康结果相关的可改变的孕前风险或健康行为的证据。从 2010 年 3 月 4 日到 2020 年 3 月 4 日，对 MEDLINE、EMBASE、Maternity and Infant Care、CINAHL 和 PsycINFO 进行了检索。纳入的研究为系统评价或观察性研究的荟萃分析，研究了可改变的孕前风险或健康行为与母婴健康结果之间的关系。两名评审员独立进行了筛选、数据提取和方法学质量评估（AMSTAR 2）。检查了重叠程度。对证据综合进行了总结。共纳入 27 项系统评价。在以下类别中确定了可改变的孕前风险和健康行为：身体成分（如超重、肥胖）、生活方式行为（如咖啡因、吸烟）、营养（如微量营养素）、环境暴露（如辐射）和生育间隔（如短孕期间隔）。与暴露相关的结果影响胚胎（如胚胎生长）、母体（如妊娠期糖尿病）、胎儿/新生儿（如早产）和儿童（如神经认知障碍）的健康。为了现实实践和政策相关性，孕前保健的循证指标应包括身体成分、生活方式、营养、环境和生育间隔。
