title: GP-initiated preconception counselling in a randomised controlled trial does not induce anxiety.
abstract: BACKGROUND
  Preconception counselling (PCC) can reduce adverse pregnancy outcome by addressing risk factors prior to pregnancy. This study explores whether anxiety is induced in women either by the offer of PCC or by participation with GP-initiated PCC.
  
  
  METHODS
  Randomised trial of usual care versus GP-initiated PCC for women aged 18-40, in 54 GP practices in the Netherlands. Women completed the six-item Spielberger State Trait Anxiety Inventory (STAI) before PCC (STAI-1) and after (STAI-2). After pregnancy women completed a STAI focusing on the first trimester of pregnancy (STAI-3).
  
  
  RESULTS
  The mean STAI-1-score (n = 466) was 36.4 (95% CI 35.4-37.3). Following PCC there was an average decrease of 3.6 points in anxiety-levels (95% CI, 2.4-4.8). Mean scores of the STAI-3 were 38.5 (95% CI 37.7-39.3) in the control group (n = 1090) and 38.7 (95% CI 37.9-39.5) in the intervention group (n = 1186).
  
  
  CONCLUSIONS
  PCC from one's own GP reduced anxiety after participation, without leading to an increase in anxiety among the intervention group during pregnancy. We therefore conclude that GPs can offer PCC to the general population without fear of causing anxiety.
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. L.C.de_Jong-Potjer@lumc.nl <L.C.de_Jong-Potjer@lumc.nl>
authors.forename: L C
authors.initials: LC
authors.lastname: de Jong-Potjer
authors.forename: J
authors.initials: J
authors.lastname: Elsinga
authors.forename: S
authors.initials: S
authors.lastname: le Cessie
authors.forename: K M
authors.initials: KM
authors.lastname: van der Pal-de Bruin
authors.forename: A Knuistingh
authors.initials: AK
authors.lastname: Neven
authors.forename: S E
authors.initials: SE
authors.lastname: Buitendijk
authors.forename: W J J
authors.initials: WJ
authors.lastname: Assendelft
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D016001:Confidence Intervals; D003376:Counseling / Q000379:methods*; D005193:Family Planning Services; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D009426:Netherlands; D010556:Personality Tests; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011261:Pregnancy Trimester, First / Q000523:psychology; D037841:Pregnant People / Q000523:psychology*; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors