Interventions and guidelines for promoting maternal and child health in the interconception period: a literature and policy review

• Published in: The Lancet (British edition) 2021-11, Vol.398, p.S88-S88
• Main Authors: Watson, Daniella, Jacob, Chandni Maria, Giles, Gareth, Hanson, Mark
• Format: Article
• Language: English
• Subjects: Charities; Children; Childrens health; Communication skills; Diabetes mellitus; Family planning; Gestational diabetes; Government agencies; Guidelines; Health care; Health policy; Human nutrition; Literature reviews; Maternal & child health; Nutrition; Offspring; Parents; Policy analysis; Primary care; Public health; Public policy; Risk assessment; Searching; Training; Websites
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(21)02631-3

Interconception is defined as the period of time between pregnancies or the first 24 months post partum. During interconception, visits for maternal and child health offer the opportunity for parents to be engaged with health messages, and the health-care professionals involved are more easily identifiable than in the preconception period. Beneficial outcomes, such as improved weight management and nutritional intake, might be reached in a shorter timescale in the interconception period than in the preconception period. We aimed to synthesise articles and guidelines on interconception care to develop recommendations for research, public health policy, and practice. In this literature review and policy analysis, we searched four academic databases (Cochrane library, Embase, MEDLINE, and Cumulative Index to Nursing and Allied Health Literature), using MeSH and free-text terms (including but not limited to “interconception”, “post-partum”, “nutrition”, “diet”, and “primary care”), for reviews published in English on nutrition for parents in the interconception and post-partum period between Jan 1, 2010, and Jan 21, 2021. Outcomes related to maternal nutrition and weight management were considered. A scoping search on interconception pilot studies and a review of guidelines published by UK public health organisations and government agencies were also conducted online. Strength of evidence was assessed for review articles by two reviewers using Health Evidence guidelines developed by McMaster University, Canada. Findings were analysed as a narrative synthesis. We included 47 documents from a scoping search of grey literature and websites, 29 full-text review articles (after screening 1780 titles and abstracts), and six pilot studies from our database search on interconception and post-partum care. 535 (30%) of 1780 titles and abstracts, and 23 (33%) of 70 full-text papers, were double-screened by another reviewer to ensure consistency. Most reviews were of strong quality (20 [69%]), followed by moderate (seven [24%]), and weak (two [7%]). Interconception care opportunities for parents include the post-partum period, family planning, routine practice, and risk assessment. Various stakeholders have a role in interconception care including general practitioners, health visitors, dieticians, nutritionists, health psychologists, community groups, local authorities, and charities. The guidelines advise increased utilisation of existing community-based services. Inter