Since foundation of Kingdom of Saudi Arabia, a huge development in all aspect of life is markedly seen. Health care is one of many that changed to be better and maternal/child mortality rate is significantly dropped. There are evidences suggested that pre-conception care can increase well-being of couples and improve child health outcome(1,2&3) . However, there is no preconception care module in Qassim and we would like to implemented in a way that provide complete and safe health service for targeted group.

           WHO define pre-conception care as: provision of biomedical, behavioral, and social health intervention to couples before conception occur. Aimed at improving their health status and reducing behaviors, individual and environmental factors that could contribute to poor maternal and child health outcomes.

1. Low risk – patients with 1-2 risk factors

2. Moderate risk - patients with 3-4 risk factors

3. High risk – patients with ≥ 5 risk factors

1. Nutritional deficiencies

2. Tobacco and substance abuse

3. Genetic disorders

4. Early pregnancy

5. Pregnancy in rapid succession

6. Infectious diseases

7. Mental health disorders

8. Chronic illness.

1. Healthy Body

• Folic Acid

• Nutrition

• Physical Activity

• Weight

• Tobacco

• Alcohol/ Drugs

• Chronic conditions

• Vaccines

• Medications

• STIs

• Oral Health

• Pregnancy spacing

2. Healthy Mind

• Mental health

• Healthy relationships

• Alcohol/ drugs

3. Healthy Environment

• Food safety

• Environmental toxins

• Workplace hazardous materials

• Home hazardous materials

• Financial stability

• Healthy relationships

• Healthy community

1. Health Education

2. Vaccination

3. Screening

4. Nutritional supplementation

5. Counseling

6. Medical and social management

1. Determining the possible conception method:

• It is easier for the doctor to estimate the date of ovulation and possible date of pregnancy, if the woman had at least one natural menstrual cycle before pregnancy.

2. Making sure that all the necessary pre-pregnancy vaccines are taken: Including: varicella, rubella because of their dangerous effects of the disease on the fetus.

• The vaccines will only be given after conducting blood tests preferably one month before trying to conceive, to check the immunity system and make sure that some vaccinations were not taken.

3. Chronic diseases, medications or dietary supplements:

• If the woman suffers from obesity or chronic diseases (such as: Diabetes, asthma, hypertension, thyroid disorders or epilepsy), then it is necessary to manage the disease before pregnancy.

• In some cases, a change in the dosage of some medications, herbs, or dietary supplements might be necessary.

• The doctor may even recommend stopping certain products when planning for pregnancy.

4. Sexually transmitted infections:

• If a woman is at risk of contracting a sexually transmitted infection or believes that she or her partner suffer from a sexually transmitted infection, then it is necessary to undergo pre-pregnancy tests and screenings to diagnose and treat the condition.

5. Family history:

• The doctor should be notified of any genetic disorders that run in the family before pregnancy so that the he can refer the woman to a specialist in genetic diseases to conduct pre-pregnancy screening.

6. The couple's age:

• Older women are at a greater risk of suffering from fertility problems, miscarriage, chromosomal abnormalities, and some pregnancy-related complications (such as: Gestational diabetes).

• The father's age may also play a role in some of these issues.

7. Previous pregnancy history:

• It is important to mention the number of previous pregnancies and method of childbirth. the doctor should be notified of any complications that the woman may have experienced during and after pregnancy, or during delivery, or in case of previous congenital birth defects.

8. The most important pre-pregnancy preparations to be followed:

• Folic Acid: Take 400 micrograms (400 mcg) of folic acid in the form of dietary supplements every day before and during pregnancy until the 12th week of pregnancy; to reduce the risk of your baby developing neural tube defects.

• Some women suffering from epilepsy, or diabetes, or those who have previously had child with neural tube defects are advised to take folic acid with a dose of 5 milligrams (5 mg).

9. Maintain a healthy weight:

• Being obese during pregnancy increases the risk of various pregnancy complications, including High blood pressure, blood clots and gestational diabetes). A healthy weight can be maintained with a balanced diet and physical activity.

10. Stop Smoking:

• Smoking is linked to a number of health risks (such as: Preterm birth, low birth weight and sudden infant death syndrome)

1. Develop, evaluate, and disseminate age-appropriate educational curricula and modules for use in school health education programs.

2. Integrate reproductive health messages into existing health promotion campaigns (e.g., campaigns to reduce obesity and smoking).

3. Conduct consumer-focused research necessary to identify terms the public understands and develop messages for promoting preconception health and reproductive awareness.

4. Design and conduct social marketing campaigns necessary to develop messages for promoting preconception health knowledge and attitudes, and behaviors among men and women of childbearing age.

5. Engage media partners to assist in depicting positive role models for lifestyles that promote reproductive health

1. Complete Blood Count (CBC)

2. Mean Corpuscular Hemoglobin (MCH)

3. Mean Corpuscular Volume (MCV)

4. Red Cell Distribution Width (RDW)

5. Ferritin

6. Iron Profile

1. World Health Organization, 2013

2. Saudi Ministry of Health Educational content, Saudi Arabia, 2020

1. Segment 4: High risk – Secondary + Tertiary Care

2. Segment 3: Moderate risk - PHC + Secondary

3. Segment 1: Low Risk – Community + PHC

4. Segment 0: No risk factor - Community

• Preconception services Toolkit & Policy.

• Preconception care and Obstetrics.

• Planning for Pregnancy.

   

• Dr Fatimah AlRibdi/ MOC lead  
• Dr. Suleiman Al Mazam/ Safe Birth lead
• Email Safe Birth System: qhc-mocsb@moh.gov.sa