Introduction
Preconception counselling is defined as the process of giving women with pre-existing medical conditions adequate information to make informed decisions regarding future pregnancies. An audit of referrals for preconception counselling to a tertiary referral obstetric medicine clinic over a 7-year period in Brisbane, Australia was conducted, and referenced against women with pre-existing medical conditions seen in the medical antenatal clinic.
Results
The electronic records for 293 women seen at preconception clinic between January 2017 and December 2023 were reviewed. Data was extracted for the source of referral, patient demographics and pre-pregnancy active medical conditions. The electronic records for 576 women with active pre-pregnancy medical conditions referred to the medical antenatal clinic over a 6-month period from January 2023 to June 2023 were also reviewed. A crude comparison was made for how many women were seen at preconception clinic compared with the number reviewed in antenatal clinic for each pre-pregnancy condition, expressed as a percentage, to gauge the uptake of preconception counselling for specific medical conditions.
Conclusion
Women from non-English speaking background who required interpreter assistance were rarely referred for preconception counselling. The uptake of preconception counselling was highest in patients who have had prior pregnancy specific conditions (e.g. severe preeclampsia or acute fatty liver of pregnancy), or certain medical conditions such as systemic lupus erythematosus, renal disease or congenital heart disease. Women with common medical conditions such as type 2 diabetes mellitus and hypertension had low rates of referral for preconception care, with significant implications for pregnancy.