Summers L, Price R A
Johns Hopkins School of Medicine, Department of Gynecology and Obstetrics, Baltimore, MD 21287-1228.
J Nurse Midwifery. 1993 Jul-Aug;38(4):188-98. doi: 10.1016/0091-2182(93)90002-x.
In 1990, the United States Public Health Service published Healthy People 2000: National Health Promotion and Disease Prevention Objectives. One of the objectives included in the family planning priority area and repeated in the maternal and infant health priority area is the following: "Increase to at least 60 percent the proportion of primary care providers who provide age-appropriate preconception care and counseling." Drawing on the guidelines proposed by the Public Health Service Expert Panel on the Content of Prenatal Care, this article describes the components of preconception care: 1) appropriate and ongoing risk assessment, 2) health promotion, and 3) medical and psychological interventions and follow-up. The organization of this article is based on a preconception class outline developed by the authors; recommendations included in the article are consistent with those of the Expert Panel. After discussing opportunities for providing preconception care, this article addresses: 1) helping women evaluate their psychological readiness; 2) evaluating physical readiness; 3) the examination and concerns of the father; 4) evaluating the need for genetic counseling; 5) creating a positive environment for conception; 6) discontinuing family planning methods and timing conception; and 7) choosing a provider and birth place.
1990年，美国公共卫生服务部发布了《2000年健康人群：国家健康促进和疾病预防目标》。计划生育优先领域中包含且母婴健康优先领域中再次提及的目标之一如下：“将提供适龄孕前保健和咨询的初级保健提供者的比例提高至至少60%。” 本文借鉴公共卫生服务产前保健内容专家小组提出的指南，描述了孕前保健的组成部分：1）适当且持续的风险评估；2）健康促进；3）医学和心理干预及随访。本文的组织结构基于作者制定的孕前课程大纲；文中包含的建议与专家小组的建议一致。在讨论提供孕前保健的机会后，本文探讨了以下内容：1）帮助女性评估其心理准备情况；2）评估身体准备情况；3）父亲的检查及担忧；4）评估遗传咨询的需求；5）营造有利于受孕的积极环境；6）停止计划生育方法并选择受孕时机；7）选择医疗服务提供者和分娩地点。
