There’s a growing focus on “preconception care” or PCC among healthcare services and in research. PCC involves interventions to manage risk factors before pregnancy and has been shown to be effective in reducing adverse maternal and pregnancy outcomes. This includes mitigating risks associated with obesity, smoking, alcohol consumption, diabetes and mental health issues. But the systematic identification and documentation of these risks, particularly in primary care settings like general practices, is understudied according to researchers.
In an effort to better understand how effectively general practices document preconception health risks, a retrospective audit was conducted in Melbourne using electronic medical records (EMRs) from 10 practices who consented to be part of the study. Researchers wanted to determine the extent to which risk factors were documented in EMRs, to know whether this was a source of good data for identifying women who may have difficulties in pregnancy. This study analysed the EMRs of one thousand women aged 18–44, focusing on the documentation of various preconception risk factors including smoking, alcohol consumption, BMI, blood pressure and general medical history
The results revealed several lifestyle factors were commonly documented in practice EMRs: smoking status was documented for 79% of women, blood pressure for 74%, alcohol consumption for 63% and BMI for 57%. Several other factors were less commonly documented as part of an EMR – diabetes (5%), mental health issues (28%) and history of chronic conditions like asthma (13%) and thyroid issues (6%). Even so, a considerable number of women had conditions that could complicate pregnancy, including mental health issues (28%), obesity (24%), and high blood pressure (7%). Overall, the EMR documentation provided a rich record to help women planning to become pregnant.
Although EMRs are currently underused for this purpose, the authors say that enhancing their documentation could significantly improve the delivery of PCC and lead to targeted interventions for high-risk groups. The authors believe that for EMRs to contribute to preconception care effectively, it’s essential for primary care providers to prioritise the recording of information in structured fields and ensure the regular updating of data.
Further information
Preconception health risk factors documented in general practice electronic medical records: British Medical Journal
Pregnancy planning: myDr.com.au
