Valensise Herbert, Banzi Cristina, Bonin Cecilia, Dell'Avanzo Marinella, Di Simone Nicoletta, Farsetti Daniele, Manganello Francesca, Mecacci Federico, Serena Caterina, Villaccio Barbara, Viora Elsa
Department of Surgical Sciences, Tor Vergata University, Rome, Italy.
Division of Obstetrics and Gynecology, Policlinico Casilino, Rome, Italy.
Int J Womens Health. 2025 Jul 2;17:1897-1909. doi: 10.2147/IJWH.S513360. eCollection 2025.
The preconceptional period is crucial for women and couples who desire children as it influences the progress and outcomes of a healthy pregnancy. Preconceptional care is now an accepted paradigm by most healthcare professionals. However, its implementation in healthcare programs is still in the early stages. Preconceptional care starts with communication and a collection of personal and family medical history. It then encompasses a variety of recommendations for lifestyle interventions, as well as preventive laboratory tests. This review will summarize current recommended procedures, from nutritional to disease screening, and their impact on pregnancy outcomes. Folic acid supplementation has been shown to significantly decrease complications such as neural tube defects, and is now widely recommended during the preconceptional phase. Additionally, nutritional supplementation, including the intake of vitamins D and B12, has been linked to healthier pregnancies. Screening for ToRCH infections (toxoplasmosis, syphilis, hepatitis B, rubella, cytomegalovirus, and herpes simplex virus), as well as non-infectious conditions, may help avoid complications during pregnancy. This review will also provide an overview of current practices worldwide, focusing on the Italian context. This document will be helpful to update the medical community, especially gynecologists, on the current knowledge of the benefits of 1) maintaining a healthy nutritional state, including vitamin and mineral supplementation, 2) screening strategies for infectious and non-infectious diseases, and 3) avoiding dangerous behaviors, such as smoking, alcohol consumption, and drug use, for women and couples planning a pregnancy. It also provides suggestions on how to identify such couples to best intervene during the "window of opportunity". Finally, we aim to provide a simple decalogue, which healthcare professionals can use as a checklist. It can also be delivered directly to women or couples planning a pregnancy, reaching them with straightforward language.
对于渴望生育的女性和夫妇来说，孕前阶段至关重要，因为它会影响健康怀孕的进程和结果。孕前保健现已成为大多数医疗保健专业人员认可的模式。然而，其在医疗保健项目中的实施仍处于早期阶段。孕前保健始于沟通以及收集个人和家族病史。随后，它涵盖了各种生活方式干预建议以及预防性实验室检查。本综述将总结当前推荐的程序，从营养到疾病筛查，以及它们对妊娠结局的影响。已证明补充叶酸可显著降低神经管缺陷等并发症的发生率，现在广泛建议在孕前阶段进行补充。此外，包括摄入维生素D和B12在内的营养补充与更健康的怀孕有关。筛查TORCH感染（弓形虫病、梅毒、乙型肝炎、风疹、巨细胞病毒和单纯疱疹病毒）以及非感染性疾病，可能有助于避免怀孕期间的并发症。本综述还将概述全球范围内的当前做法，重点关注意大利的情况。本文将有助于向医学界，尤其是妇科医生，更新关于以下方面的当前知识：1）保持健康营养状态，包括补充维生素和矿物质；2）感染性和非感染性疾病的筛查策略；3）对于计划怀孕的女性和夫妇，避免吸烟、饮酒和吸毒等危险行为。它还就如何识别此类夫妇以便在“机会之窗”期间进行最佳干预提供了建议。最后，我们旨在提供一个简单的十诫，医疗保健专业人员可以将其用作检查表。它也可以直接提供给计划怀孕的女性或夫妇，用通俗易懂的语言传达给他们。
