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Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data

Abstract:
Background
Optimising women's pre-pregnancy health is a policy priority for benefits spanning pregnancy and throughout the mother and baby's life. In the UK pre-pregnancy care (PPC) tends to be delivered in primary care, with the onus on women to seek services. We aimed to describe women’s engagement with General Practice (GP) in the year preceding pregnancy, including specific PPC; to explore whether women with recognised risk factors for poor pregnancy outcomes receive targeted care.

Methods
Data for women aged 18-48yrs and registered for  12 months with a GP on 01/01/2017, were drawn from English Clinical Practice Research Datalink (CPRD) GOLD, a source of electronic health record data. Demographic characteristics, lifestyle factors and health conditions were described. CPRD Pregnancy Register and linked hospital data were used to identify pregnancies in 2017/18 and to describe PPC in the year preceding pregnancy.

Results
Of 193,578 women included, 14,326 had a confirmed pregnancy. 7.6% of the pregnant women had records indicating specific PPC in the preceding year, whilst 41.0% had records of health promotion (advice on nutrition, smoking, weight, alcohol and contraception). More women with pre-existing medical conditions received health promotion (46.0%-83.9% for various risk groups), although the levels of PPC remained low (4.7%-14.9%).

Conclusions
PPC was rarely recorded, likely reflecting low levels of consultation for, or discussion of, pregnancy planning. This represents a missed opportunity for maximising women’s health, particularly in those with recognised risk factors for poor pregnancy, perinatal and longer-term outcomes.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1186/s12889-025-21728-1

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0001-5042-1151
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0001-9554-6337
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0003-2404-5644
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
NPEU
Role:
Author
ORCID:
0000-0003-2233-6544


More from this funder
Funder identifier:
https://ror.org/015ah0c92
Grant:
PR-PRU-1217–21202
970014
Funding agency for:
Kenyon, S


Publisher:
BioMed Central
Journal:
BMC Public Health More from this journal
Volume:
25
Issue:
1
Article number:
1101
Publication date:
2025-03-22
Acceptance date:
2025-01-31
DOI:
EISSN:
1471-2458
ISSN:
1471-2458


Language:
English
Keywords:
Pubs id:
2092809
Local pid:
pubs:2092809
Deposit date:
2025-02-28
ARK identifier:

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