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 describ...

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Main Authors: Yangmei Li, Jennifer J. Kurinczuk, Fiona Alderdice, Maria A. Quigley, Oliver Rivero-Arias, Julia Sanders, Sara Kenyon, Dimitrios Siassakos, Nikesh Parekh, Suresha De Almeida, Claire Carson
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Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21728-1
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author Yangmei Li
Jennifer J. Kurinczuk
Fiona Alderdice
Maria A. Quigley
Oliver Rivero-Arias
Julia Sanders
Sara Kenyon
Dimitrios Siassakos
Nikesh Parekh
Suresha De Almeida
Claire Carson
author_facet Yangmei Li
Jennifer J. Kurinczuk
Fiona Alderdice
Maria A. Quigley
Oliver Rivero-Arias
Julia Sanders
Sara Kenyon
Dimitrios Siassakos
Nikesh Parekh
Suresha De Almeida
Claire Carson
author_sort Yangmei Li
collection DOAJ
description 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 $$\ge$$ ≥ 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.
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spelling doaj-art-ab2009d9f30e46e9b444c139db33e0482025-08-20T01:48:34ZengBMCBMC Public Health1471-24582025-03-0125111210.1186/s12889-025-21728-1Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health dataYangmei Li0Jennifer J. Kurinczuk1Fiona Alderdice2Maria A. Quigley3Oliver Rivero-Arias4Julia Sanders5Sara Kenyon6Dimitrios Siassakos7Nikesh Parekh8Suresha De Almeida9Claire Carson10NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordNIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordNIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordNIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordNIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordSchool of Healthcare Sciences, Cardiff UniversityInstitute of Applied Health Research, University of BirminghamEGA Institute for Women’s Health, University College LondonPublic Health and Wellbeing, Royal Borough of GreenwichNHS South West London CCGNIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of OxfordAbstract 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 $$\ge$$ ≥ 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.https://doi.org/10.1186/s12889-025-21728-1Preconception careGeneral practiceGeneral practitionersPrimary health careHealth promotion
spellingShingle Yangmei Li
Jennifer J. Kurinczuk
Fiona Alderdice
Maria A. Quigley
Oliver Rivero-Arias
Julia Sanders
Sara Kenyon
Dimitrios Siassakos
Nikesh Parekh
Suresha De Almeida
Claire Carson
Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
BMC Public Health
Preconception care
General practice
General practitioners
Primary health care
Health promotion
title Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
title_full Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
title_fullStr Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
title_full_unstemmed Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
title_short Pre-pregnancy care in general practice in England: cross-sectional observational study using administrative routine health data
title_sort pre pregnancy care in general practice in england cross sectional observational study using administrative routine health data
topic Preconception care
General practice
General practitioners
Primary health care
Health promotion
url https://doi.org/10.1186/s12889-025-21728-1
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