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Monday, October 29, 2007 - 4:00 PM
72

Preconception Care: An Opportunity to Prevent Maternal Morbidity and Mortality

Renee Samelson1, Donna Montalto Williams2, Catriona Stevenson2, Adiel Fleischer3, and Cynthia Chazotte4. (1) Division of Family Health, New York State Department of Health, Corning Tower Room 890, Empire State Plaza, Albany, NY, USA, (2) American College of Obstetricians and Gynecologists, Distirct II/NY, 152 Washington Avenue, 3rd Floor, Albany, NY, USA, (3) Department of Obstetrics and Gynecology, North Shore-Long Island Jewish Health System, 270-05 76th Avenue, New Hyde Park, NY, USA, (4) Department of Obstetrics, Gynecology and Women's Health, Montefiore Medical Center/Albert Einstein College of Medicine, Weiler Hospital, 1825 Eastchester Road, Room 703, Bronx, NY, USA


Background:
In the first triennial report of the Safe Motherhood Initiative (SMI), a voluntary program of New York State Department of Health (NYS DOH) and the American College of Obstetricians and Gynecologists, District II/NY (ACOG) to review maternal deaths in New York State (NYS), sub-optimal management of chronic medical diseases was identified as a risk factor for maternal death. In addition, NYS DOH wanted to respond to the recent publications that linked the use of ACE inhibitors to congenital anomalies. Both of these issues are best addressed in the preconception period as summarized in the CDC's Recommendations to Improve Preconception Health and Health Care. NYS DOH and ACOG collaborated to develop educational tools on preconception health for health care professionals to use.

Objectives:
1. To educate health care professionals concerning the importance of preconception health to improve pregnancy outcomes including decreasing maternal mortality.
2. To provide tools that the health care professional can use to easily incorporate preconception care into their daily practice.


Methods:
ACOG convened a committee to develop an educational booklet, entitled “Preconception Care - A Guide for Optimizing Pregnancy Outcomes," which addressed preconception management of chronic disease to decrease maternal morbidity and mortality. NYS DOH developed a laminated pocket card that health care professionals could use as a checklist to incorporate preconception care into their daily practice.

Results:
NYS DOH and ACOG collaborated to send a joint mailing with a correspondence signed by both organizations to approximately 3,000 practicing obstetricians and ob-gyn residents in NYS. An evaluation of the educational materials is on-going through a web based survey. To date, ACOG has received numerous calls requesting additional copies of both educational tools.

Conclusion and implications for practice:
1. State health departments and professional organizations can collaborate to deliver a stronger educational message to health care professionals, than either organization can deliver independently.
2. Future dissemination will include mailings to primary care physicians, urgent visit centers, and emergency rooms.

See more of B-2 Moving Beyond Pregnancy: Strategies for Impacting Interconceptional Services
See more of The 2nd National Summit on Preconception Health and Health Care