'Parents to be' The effectiveness of systematic population-based preconception advice and counselling initiated by GP's.

'Parents to be' is a project that evaluates routine preconception advice and counselling given to couples before pregnancy (PAC), initiated and given by their own general practitioner (GP) in order to prevent adverse pregnancy outcomes. The couples' personal situation is evaluated with respect to risk factors for the pregnancy and the unborn child. Questions are asked about the couples' medical history, medication, lifestyle (smoking, alcohol consumption and nutritional habits) as well as about hereditary and congenital disorders in the family. If specific risk factors are found the couple receives information about these personal risk factors along with information on general risk factors for pregnancy. The GP offers general and specific health education and refers to a specialist if genetic counselling is needed. The effect of routine PAC on health behaviour, risk perception, frequency of risk factors in the general population is studied.

At least 20% of the pregnancies in the Netherlands end in an adverse pregnancy outcome (spontaneous abortion, preterm birth, low birth weight, perinatal death, congenital anomaly). Information on risk factors before pregnancy together with preventive measures (preconcpetion counseling) will lead to behavioural changes and thus to reduced adverse pregnancy outcomes.

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In the intervention group women 18-40 years received an invitation for preconception counseling. When interested and contemplating a pregnancy within a year a risk-assessment questionnaire was used to systematically assess risks of the couple. Counseling was provided based on risks identified as well as risk, which apply to all women. The control group received care as usual.