Ten years of experience in periconceptional care.
OBJECTIVE
To describe the methods of the periconceptional care, consisting of counselling, examinations and medical intervention in Hungary. The term periconceptional is used instead of preconceptional because early postconceptional period is also involved to this service.


METHODS
A model was developed based on three steps: check-up of reproductive health (i.e. preconceptional screening), the 3-month preparation for conception, and better protection in early pregnancy for the most sensitive early development of embryo for voluntary and eligible couples. Data of 8837 female and 7600 male participants from the coordinating centre of the Hungarian periconceptional care between 1 February 1984 and 31 January 1994 are summarized. Mean maternal age was 25.8+/-3.4 years, 84 and 60% of female participants were primiparae, and had high education (> or = 13 classes), respectively.


RESULTS
It was possible to establish periconceptional care performed and/or supervised by qualified nurses. Participants with positive family history, case history and where genitourinary infections were detected, had a more effective flow towards secondary care. Infertile couples were diagnosed and treated sooner. The periconceptional care is effective for the introduction of periconceptional folic acid/multivitamin supplementation and for the reduction of smoking and alcohol consumption in females in the preconceptional period. The rate of major congenital abnormalities (20.6/1000) was significantly lower than expected (35/1000).


CONCLUSIONS
Periconceptional care is feasible and has many benefits. Thus, proper preparation for conception is the earliest and probably the most important method of health promotion in general, particularly for the prevention of congenital abnormalities.
Department of Human Genetics and Teratology, National Institute of Public Health/WHO Collaborating Centre for the Community Control of Hereditary Diseases, Budapest, Hungary.
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Czeizel
D000328:Adult; D000428:Alcohol Drinking; D000013:Congenital Abnormalities / Q000517:prevention & control; D004311:Double-Blind Method; D004522:Educational Status; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D010298:Parity; D016742:Preconception Care / Q000191:economics / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D012907:Smoking; D011795:Surveys and Questionnaires; D014815:Vitamins / Q000627:therapeutic use
D014815:Vitamins