Systematic development of an evidence-based website on preconception care

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Abstract

Introduction

In February 2015, the Flemish Minister of Welfare, Public Health and Family launched a website on preconception care: ‘gezondzwangerworden.be’. The website was developed in response to the lack of comprehensive communication on preconception care and the inadequate intake of folic acid among Flemish women. Despite the international recommendation to take 400 μg folic acid on a daily basis one month before conception until 12 weeks of pregnancy, studies show a lack of compliance in women wanting to become pregnant.

Procedure

A compilation of evidence was made through reviewing well-established guidelines on preconception and prenatal care. The quality of guidelines was assessed by means of AGREE II. The topics included in the website were selected by an internal committee of 5 experts and an external committee of 16 experts. Content validation was carried out by 40 experts in preconception care or related topics.

Results

The above-described procedure resulted in an evidence-based website with a selection of relevant, validated information for both women and men who plan a pregnancy and professionals who are consulted by these people.

Evaluation and recommendation

The website is currently attracting a constant number of 100 to 200 visitors a day. The information on folic acid is among the most requested, which is an important finding with regard to the policy objectives on preconception care. More research is needed in order to evaluate the use and effect of the website more thoroughly.

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Most cited references 3

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Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

J. F. Sneddon, J Densem, N Wald … (1991)

A randomised double-blind prevention trial with a factorial design was conducted at 33 centres in seven countries to determine whether supplementation with folic acid (one of the vitamins in the B group) or a mixture of seven other vitamins (A,D,B1,B2,B6,C and nicotinamide) around the time of conception can prevent neural tube defects (anencephaly, spina bifida, encephalocele). A total of 1817 women at high risk of having a pregnancy with a neural tube defect, because of a previous affected pregnancy, were allocated at random to one of four groups--namely, folic acid, other vitamins, both, or neither. 1195 had a completed pregnancy in which the fetus or infant was known to have or not have a neural tube defect; 27 of these had a known neural tube defect, 6 in the folic acid groups and 21 in the two other groups, a 72% protective effect (relative risk 0.28, 95% confidence interval 0.12-0.71). The other vitamins showed no significant protective effect (relative risk 0.80, 95% Cl 0.32-1.72). There was no demonstrable harm from the folic acid supplementation, though the ability of the study to detect rare or slight adverse effects was limited. Folic acid supplementation starting before pregnancy can now be firmly recommended for all women who have had an affected pregnancy, and public health measures should be taken to ensure that the diet of all women who may bear children contains an adequate amount of folic acid.

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The clinical content of preconception care: an overview and preparation of this supplement.

Brian Jack, Hani K. Atrash, Dean V Coonrod … (2008)

In June 2005, the Select Panel on Preconception Care established implementation workgroups in 5 areas (clinical, public health, consumer, policy and finance, and research and surveillance) to develop strategies for the implementation of the Centers for Disease Control and Prevention recommendations on preconception health and healthcare. In June 2006, members of the clinical workgroup asked the following questions: what are the clinical components of preconception care? What is the evidence for inclusion of each component in clinical activities? What health promotion package should be delivered as part of preconception care? Over the next 2 years, the 29 members of the clinical workgroup and > 30 expert consultants reviewed in depth > 80 topics that make up the content of the articles that are contained in this supplement. Topics were selected on the basis of the effect of preconception care on the health of the mother and/or infant, prevalence, and detectability. For each topic, the workgroup assigned a score for the strength of the evidence that supported its inclusion in preconception care and assigned a strength of the recommendation. This article summarizes the methods that were used to select and review each topic and provides a summary table of the recommendations.

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Appraising a tool for guideline appraisal (the AGREE II instrument).

Antonio L. Dans, Leonila Dans (2010)

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Author and article information

Journal

Journal ID (nlm-ta): Ups J Med Sci

Journal ID (iso-abbrev): Ups. J. Med. Sci

Journal ID (publisher-id): IUPS

Title: Upsala Journal of Medical Sciences

Publisher: Taylor & Francis

ISSN (Print): 0300-9734

ISSN (Electronic): 2000-1967

Publication date (Print): November 2016

Publication date (Electronic): 30 August 2016

Volume: 121

Issue: 4

Pages: 264-270

Affiliations

[a ]Department of Midwifery, Health Education, Vives University College, Kortrijk, Belgium;

[b ]Department of Obstetrics and Gynecology, Ghent University Hospital, Ghent, Belgium;

[c ]Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium;

[d ]Department of Agricultural Economics, Faculty of Biosciences Engineering, Ghent University, Ghent, Belgium;

[e ]University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium;

[f ]Public Health Agency ‘Zorg & Gezondheid’, Flemish Government, Brussels, Belgium

Author notes

CONTACT Ilse Delbaere ilse.delbaere@ 123456vives.be Department of Midwifery, Health Education, Vives University College, Kortrijk, Belgium

Author information

An De Sutter http://orcid.org/0000-0002-2540-8307

Xavier Gellynck http://orcid.org/0000-0002-8908-3310

Article

Publisher ID: iups-121-264

DOI: 10.1080/03009734.2016.1216481

PMC ID: 5098491

PubMed ID: 27586661

SO-VID: 9c86342c-0d08-4109-9e4a-7c7892b59469

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 21 April 2016

Date revision received : 01 July 2016

Date accepted : 17 July 2016

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Systematic development of an evidence-based website on preconception care

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Abstract

Introduction

Procedure

Results

Evaluation and recommendation

Related collections

International Journal of Applied Technology in Medical Sciences

Most cited references 3

Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group.

The clinical content of preconception care: an overview and preparation of this supplement.

Appraising a tool for guideline appraisal (the AGREE II instrument).

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