Prekonsepsiyonel Dönemde Risk Farkındalığı

Yıl 2025, Cilt: 34 Sayı: 5, 376 - 384, 17.11.2025

İmran Ülkü Alev Gökgöz , Hava Özkan

Öz

Prekonsepsiyonel dönem, potansiyel ebeveynlerin ve gelecek nesillerin sağlığını doğrudan etkileyen kritik bir evredir. Dünya genelinde birçok doğum, plansız gebelikler sonucu gerçekleşmekte ve kadınlar genellikle gebelik tanısı konulduktan sonra risk faktörlerine karşı önlem almaya başlamaktadır. Bu durum hem anne hem de fetüs için olumsuz sağlık sonuçlarına yol açabilmektedir. Bu nedenle, kadınların ve partnerlerin konsepsiyon öncesi dönemde risk farkındalığının artırılması, risklerin belirlenmesi ve yönetilmesi açısından büyük önem taşımaktadır. Risk farkındalığı, bireylerin kendi sağlıklarını ve bebeklerinin sağlığını iyileştirmenin yanı sıra yaşam kalitelerini de olumlu yönde etkilemektedir. Ancak, prekonsepsiyonel dönemde bireylerin sağlık hizmetlerine erişimini engelleyen çeşitli faktörler bulunmaktadır. Bu engellerin aşılması ve konsepsiyon öncesi sağlık hizmetlerinin yaygınlaştırılması için bireylerin risk farkındalığının ve bilgi düzeyinin artırılması gerekmektedir. Bu süreçte, bireyselleştirilmiş eğitim ve danışmanlık hizmetlerinin yanı sıra teknolojik araçlar ve mobil uygulamaların kullanımı etkili bir yöntem olarak öne çıkmaktadır. Ayrıca, toplum tabanlı programlar da risk farkındalığının artırılmasında önemli bir rol oynamaktadır. Ebeler, bu süreçlere aktif olarak dahil olarak toplum sağlığının iyileştirilmesinde kilit bir rol üstlenmektedir. Bu derleme, prekonsepsiyonel dönemde çiftlerin risk farkındalığını artırmanın önemi ve bu süreçte karşılaşılan sağlık problemlerini ele alarak, bireylerin yaşam kalitesini artırmaya yönelik kapsamlı bir perspektif sunmayı hedeflemektedir.

Anahtar Kelimeler

döllenme öncesi bakım , ebelik , risk , farkındalık

Risk Awareness in the Preconceptional Period

Öz

The preconception period is a critical stage that directly affects the health of potential parents and future generations. Globally, many births occur as a result of unplanned pregnancies, and women often begin to take precautions against risk factors only after the diagnosis of pregnancy. This situation may lead to adverse health outcomes for both the mother and the fetus. Therefore, increasing risk awareness, identifying risks, and managing them during the preconception period are of great importance for women and their partners. Risk awareness not only contributes to improving individuals’ own health and their babies’ health but also positively influences their quality of life. However, various factors hinder individuals’ access to health services during the preconception period. To overcome these barriers and expand preconception health services, it is necessary to enhance individuals’ level of knowledge and risk awareness. In this process, individualized education and counseling services, as well as the use of technological tools and mobile applications, emerge as effective strategies. In addition, community-based programs play a significant role in increasing risk awareness. Midwives play an active part in these processes and assume a key role in improving public health. This review aims to provide a comprehensive perspective to improve the quality of life of individuals by addressing the importance of increasing the risk awareness of couples in the preconceptional period and the health problems encountered in this process.

Anahtar Kelimeler

awareness , midwifery , risk , preconception care

Kaynakça

• Nypaver C, Arbour M, Niederegger E. Preconception Care: Improving the health of women and families. Journal of Midwifery & Women’s Health. 2016;61(3):356–64. https://doi.org/10.1111/jmwh.12465. Accessed January 04, 2025
• Bortolus R, Oprandi NC, Rech Morassutti F, Marchetto L, Filippini F, Agricola E, and et al. Why women do not ask for information on preconception health? A qualitative study. BMC Pregnancy and Childbirth. 2017;17(1):5. https://doi.org/10.1186/s12884-016-1198-z. Accessed January 13, 2025
• Atrash H, Jack BW, Johnson K. Preconception care: A 2008 update. Current Opinion in Obstetrics and Gynecology. 2008;20(6):581. https://doi.org/10.1097/GCO.0b013e328317a27c. Accessed January 13, 2025
• Gardiner PM, Nelson L, Shellhaas CS, Dunlop AL, Long R, Andrist S, and et al. The clinical content of preconception care: nutrition and dietary supplements. American Journal of Obstetrics and Gynecology. 2008;199(6, Supplement B):S345–56. https://doi.org/10.1016/j.ajog.2008.10.049. Accessed January 18, 2025
• United Nations Western Europe. Sustainable Development Goals (SDG 3). Available at: https://unric.org/en/sdg-3/. Accessed January 27, 2025.
• Dunlop AL, Jack BW, Bottalico JN, Lu MC, James A, Shellhaas CS, and et al. The clinical content of preconception care: Women with chronic medical conditions. American Journal of Obstetrics and Gynecology. 2008;199(6, Supplement B):S310–27. https://doi.org/10.1016/j.ajog.2008.08.031. Accessed January 04, 2025
• Hemsing N, Greaves L, Poole N. Preconception health care interventions: A scoping review. Sexual & Reproductive Healthcare. 2017;14:24–32. https://doi.org/10.1016/j.srhc.2017.08.004. Accessed January 12, 2025
• World Health Organization. Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity: World Health Organization Headquarters, Geneva, 6–7 February 2012: Meeting report. Available at: https://iris.who.int/handle/10665/78067. Accessed January 04, 2025
• Benedetto C, Borella F, Divakar H, O’Riordan SL, Mazzoli M, Hanson M, and et al. FIGO Preconception Checklist: Preconception care for mother and baby. International Journal of Gynecology & Obstetrics. 2024;165(1):1–8. https://doi.org/10.1002/ijgo.15446. Accessed January 27, 2025
• Kizirian N, Black K, Musgrave L, Hespe C, Gordon A. Understanding and provision of preconception care by general practitioners. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2019;59:10132 https://doi.org/10.1111/ajo.12962. Accessed November 02, 2024.
• Lang AY, Boyle JA, Fitzgerald GL, Teede H, Mazza D, Moran LJ, and et al. Optimizing preconception health in women of reproductive age. Minerva Ginecologica. 2018;70(1):99–119. https://doi.org/10.23736/S0026-4784.17.04140-5. Accessed January 18, 2025
• ACOG Committee Opinion No. 766 Summary: Approaches to limit intervention during labor and birth. Obstetrics and Gynecology. 2019;133(2):406–8. https://doi.org/10.1097/AOG.0000000000003081. Accessed January 02, 2025
• Moos MK. From Concept to practice: Reflections on the Preconception health agenda. Journal of Women’s Health. 2010;19(3):561–7. https://doi.org/10.1089/jwh.2009.1411. Accessed January 12, 2025
• Raghuraman N, Tuuli MG. Preconception care as an opportunity to optimize pregnancy outcomes. JAMA. 2021;326(1):79–80. https://doi.org/10.1001/jama.2020.27244. Accessed January 28, 2025
• Jacob MM. Indigenous studies speaks to American sociology: The need for individual and social transformations of Indigenous education in the USA. Social Sciences. 2017;7(1):1. https://doi.org/10.3390/socsci7010001. Accessed January 18, 2025
• Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, and et al. Origins of lifetime health around the time of conception: Causes and consequences. Lancet (London, England). 2018;391(10132):1842–52. https://doi.org/10.1016/S0140-6736(18)30312-X. Accessed January 12, 2025
• Carmichael SL, Ma C, Feldkamp ML, Shaw GM. Comparing usual dietary intakes among subgroups of mothers in the year before pregnancy. Public Health Reports. 2018;134(2):155–63. https://doi.org/ 10.1177/0033354918821078. Accessed January 12,2025
• Seshadri S, Oakeshott P, Nelson-Piercy C, Chappell LC. Prepregnancy care. BMJ (Clinical research ed.). 2012;344:e3467. https://doi.org/10.1136/bmj.e3467. Accessed January 08, 2025
• Yang Y, Zhang DY, Li YL, Zhang M, Wang PH, Liu XH, and et al. Prevalence, correlates, and network analysis of Internet addiction symptoms among Chinese pregnant and postpartum women. Journal of Affective Disorders. 2022;298:126–33. https://doi.org/10.1016/j.jad.2021.10.092. Accessed January 08, 2025
• Sansone A, Di Dato C, de Angelis C, Menafra D, Pozza C, Pivonello R, and et al. Smoke, alcohol and drug addiction and male fertility. Reproductive Biology and Endocrinology. 2018;16(1):3. https://doi.org/10.1186/s12958-018-0320-7. Accessed January 12, 2025
• Day J, Savani S, Krempley BD, Nguyen M, Kitlinska JB. Influence of paternal preconception exposures on their offspring: Through epigenetics to phenotype. American Journal of Stem Cells. 2016;5(1):11–8.
• Khandwala YS, Baker VL, Shaw GM, Stevenson DK, Lu Y, Eisenberg ML. Association of paternal age with perinatal outcomes between 2007 and 2016 in the United States: Population based cohort study. BMJ. 2018;363:k4372. https://doi.org/10.1136/bmj.k4372. Accessed January 28, 2025
• Abate BB, Kumsa H, Kibret GA, Wodaynew T, and et al. Preconception folic acid and multivitamin supplementation for the prevention of neural tube defect: An umbrella review of systematic review and meta-analysis. Neuroepidemiology, 2025;59(4):412–25. https://doi.org/10.1159/000539803 Accessed August 20, 2025
• Türkiye İstatistik Kurumu. İstatistiklerle Aile, 2024 Available at: https://data.tuik.gov.tr/Bulten/Index?p=Istatistiklerle-Aile-2024-53898, Accessed August 20, 2025
• Mitchell EW, Levis DM, Prue CE. Preconception health: Awareness, planning, and communication among a sample of US men and women. Maternal and Child Health Journal. 2012;16(1):31–9. https://doi.org/10.1007/s10995-010-0663-y. Accessed January 02, 2025
• Morgan MA, Hawks D, Zinberg S, Schulkin J. What obstetrician-gynecologists think of preconception care. Maternal and Child Health Journal. 2006;10(Suppl 1):59–65. https://doi.org/10.1007/s10995-006-0086-y. Accessed January 02, 2025
• Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. Türkiye Nüfus ve Sağlık Araştırması. 2018; Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü Yayınları. 2018. Ankara
• Lammers CR, Hulme PA, Wey H, Kerkvliet J, Arunachalam SP. Understanding women’s awareness and access to preconception health care in a rural population: A cross sectional study. Journal of Community Health. 2017;42(3):489–99. https://doi.org/10.1007/s10900-016-0281-8. Accessed January 04, 2025
• Zaçe D, Orfino A, Mariaviteritti A, Versace V, Ricciardi W, Di Pietro ML. A comprehensive assessment of preconception health needs and interventions regarding women of childbearing age: A systematic review. J Prev Med Hyg. 2022;63(1):E174-99. https://doi.org/10.15167/2421-4248/jpmh2022.63.1.2391. Accessed January 12, 2025
• Bello JK, Adkins K, Stulberg DB, Rao G. Perceptions of a reproductive health self-assessment tool (RH-SAT) in an urban community health center. Patient Education and Counseling. 2013;93(3):655–63. https://doi.org/10.1016/j.pec.2013.09.004. Accessed January 02, 2025
• Suto M, Inaoka K, Suzuki D, Nitamizu A, Arata N, Ota E. Behavior changes to promote preconception health: A systematic review. BMC Women’s Health. 2025;25:23. https://doi.org/10.1186/s12905-024-03544-8. Accessed January 22, 2025
• Temel S, van Voorst SF, Jack BW, Denktaş S, Steegers EAP. Evidence-based preconceptional lifestyle interventions. Epidemiologic Reviews. 2014;36:19–30. https://doi.org/10.1093/epirev/mxt003. Accessed January 22, 2025
• Biermann J, Dunlop AL, Brady C, Dubin C, Brann A. Promising practices in preconception care for women at risk for poor health and pregnancy outcomes. Maternal and Child Health Journal. 2006;10(5 Suppl):S21-28. https://doi.org/10.1007/s10995-006-0097-8. Accessed January 02, 2025
• Godfrey JR, Nachtigall MJ. Toward optimal health: An update on preconception care. Journal of Women’s Health. 2009;18(6):779–83.
• Nilsen RM, Daltveit AK, Iversen MM, Sandberg MG, Schytt E, Small R, and et al. Preconception Folic acid supplement use in ımmigrant women (1999–2016). Nutrients. 2019;11(10):2300. https://doi.org/10.3390/nu11102300. Accessed January 12, 2025
• Montanaro C, Lacey L, Robson L, Estill A, Vukovic S. Preconception care: A Technology-based Model for delivery in the Primary Care Setting supported by Public Health. Maternal and Child Health Journal. 2019;23(12):1581–6. https://doi.org/10.1007/s10995-019-02806-4. Accessed January 02, 2025
• Hasdemir Ö. Web Tabanlı Prekonsepsiyonel Bakım ve Danışmanlığın Kadınlarda Risk Farkındalığına ve Sağlıklı Yaşam Biçimi Davranışına Etkisi. [Doktora Tezi] [Sivas]: Sivas Cumhuriyet Üniversitesi. Sağlık Bilimleri Enstitüsü; 2023.
• Harelick L, Viola D, Tahara D. Preconception health of low socioeconomic status women: assessing knowledge and behaviors. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health. 2011;21(4):272–6. https://doi.org/10.1016/j.whi.2011.03.006. Accessed January 28, 2025
• Clark H, Royal P, Wright P, Robillard Webb L, De Barra D, Murray A, and et al. A Preconception Care Strategy. 2023 May Available at: https://childrensalliance.org.uk/wp-content/uploads/2023/05/2-Preconception-care-strategy-report-University-of-Southampton.pdf. Accessed January 28, 2025
• Shawe J, Delbaere I, Ekstrand M, Hegaard HK, Larsson M, Mastroiacovo P, Stern J, Steegers E, Stephenson J, & Tydén T. Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. The European Journal of Contraception & Reproductive Health Care: The Official Journal of the European Society of Contraception, 2015;20(2):77–87.