References and links to more resources

Preconception health

Centers for Disease Control and Prevention. (2006). Recommendations to improve preconception health and health care — United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR, 55(No. RR-06); 1-23. A summary of the results including goals, vision and action steps is also available here. 

Michael, C. (2007). Recommendations for preconception care. Am Fam Physician, 76, 397-400.

Moos, M.K. & Bernstein, P. The National Preconception Curriculum & Resources Guide for Clinicians, Module 1: Preconception care: What it is and what it isn’t. (2009). 

Moos, M.K, et. al (2008). Healthier women, healthier reproductive outcomes: Recommendations for the routine care of all women of reproductive age. AJOG, 199(6 Suppl 2):S280-9. 

Preconception care: Healthy women today, healthy babies tomorrow. National Association of County & City Health Officials issue brief. 

Verbiest, S., Cox, E., et al. (2007). Looking back, moving forward: North Carolina’s path to healthier women and babies. 

Reproductive life planning

Coming soon!

Healthy weight

Abenhaim, H. A., Kinch, R. A., Morin, L., Benjamin, A., & Usher, R. (2007). Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes. Archives of Gynecology and Obstetrics, 275(1), 39-43. 

Baeten, J., Bukusi, E., & Lambe, M. (2001). Pregnancy complications and outcomes among overweight and obese nulliparous women. American Journal of Public Health, 91(3), 436.

Bardia, A., Holtan, S. G., Slezak, J. M., & Thompson, W. G. (2007). Diagnosis of obesity by primary care physicians and impact on obesity management. Paper presented at the Mayo Clinic Proceedings, 82(8) 927. 

Bhattacharya, S., Campbell, D. M., Liston, W. A., & Bhattacharya, S. (2007). Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health, 7, 168. doi:10.1186/1471-2458-7-168 

Bodnar, L. M., Ness, R. B., Markovic, N., & Roberts, J. M. (2005). The risk of preeclampsia rises with increasing prepregnancy body mass index. Annals of Epidemiology, 15(7), 475-482.

Boyle, M., Lawrence, S., Schwarte, L., Samuels, S., & McCarthy, W. J. (2009). Health care providers' perceived role in changing environments to promote healthy eating and physical activity: Baseline findings from health care providers participating in the healthy eating, active communities program. Pediatrics, 123(Supplement), S293. 

Budd, G. M., Mariotti, M., Graff, D., & Falkenstein, K. (2009). Health care professionals' attitudes about obesity: An integrative review. Applied Nursing Research, doi:10.1016/j.apnr.2009.05.001 

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health. NIH Publication NO. 98-4083, September 1998. http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf.

Cnattingius, S., Bergstrom, R., Lipworth, L., & Kramer, M. S. (1998). Prepregnancy weight and the risk of adverse pregnancy outcomes. The New England Journal of Medicine, 338(3), 147-152. doi:10.1056/NEJM199801153380302 

Doherty, D., Magann, E., Francis, J., Morrison, J., & Newnham, J. (2006). Pre-pregnancy body mass index and pregnancy outcomes. International Journal of Gynecology and Obstetrics, 95(3), 242-247. 

Dunkley, A. J., Stone, M. A., Patel, N., Davies, M. J., & Khunti, K. (2009). Waist circumference measurement: Knowledge, attitudes and barriers in patients and practitioners in a multi-ethnic population. Family Practice, doi:10.1093/fampra/cmp048 

Forman-Hoffman, V., Little, A., & Wahls, T. (2006). Barriers to obesity management: A pilot study of primary care clinicians. BMC Family Practice, 7, 35. doi:10.1186/1471-2296-7-35 

Galuska, D. A., Will, J. C., Serdula, M. K., & Ford, E. S. (1999). Are health care professionals advising obese patients to lose weight? JAMA, 282(16), 1576. 

Institute of Medicine and National Research Council. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, D.C.: The National Academies Press. 

Jensen, D. M., Damm, P., Sørensen, B., Mølsted-Pedersen, L., Westergaard, J. G., Ovesen, P., & Beck-Nielsen, H. (2003). Pregnancy outcome and prepregnancy body mass index in 2459 glucose-tolerant danish women. American Journal of Obstetrics and Gynecology, 189(1), 239-244. 

Kellner, S (2010). Maternal Weight: An opportunity to impact infant mortality in North Carolina. Unpublished.

Kim, S. Y., Dietz, P. M., England, L., Morrow, B., & Callaghan, W. M. (2007). Trends in pre-pregnancy obesity in nine states, 1993-2003. Obesity, 15(4) 

Lutfiyya, M. N., Nika, B., Ng, L., Tragos, C., Won, R., & Lipsky, M. S. (2008). Primary prevention of overweight and obesity: An analysis of national survey data. Journal of General Internal Medicine, 23(6), 821-823. 

Odell, L. D. (1945). The overweight obstetric patient. Journal of the American Medical Association, 128, 87-88,89,90. 

O'Donnell, D. C., Brown, C. M., & Dastani, H. B. (2006). Barriers to counseling patients with obesity: A study of texas community pharmacists. Journal of the American Pharmacists Association, 46(4), 465-471. 

Office of Disease Prevention & Health Promotion, U.S. Department of Health and Human Services. (2009). Developing healthy people 2020: Maternal, infant and child health. Retrieved February 02, 2010, from http://www.healthypeople.gov.libproxy.lib.unc.edu/HP2020/Objectives/ViewObjective.aspx?Id=184&TopicArea=Maternal%2c+Infant+and+Child+Health&Objective=MICH+HP2020%E2%80%9315&TopicAreaId=32

Potter, M. B., Vu, J. D., & Croughan-Minihane, M. (2001). Weight management: What patients want from their primary care physicians. Journal of Family Practice, 50(6), 513-519. 

Power, M. L., Cogswell, M. E., & Schulkin, J. (2006). Obesity prevention and treatment practices of US obstetrician-gynecologists. Obstetrics & Gynecology, 108(4), 961. 

Rosenberg, T. J., Garbers, S., Chavkin, W., & Chiasson, M. A. (2003). Prepregnancy weight and adverse perinatal outcomes in an ethnically diverse population. Obstetrics & Gynecology, 102(5, Part 1), 1022. 

Ruelaz, A. R., Diefenbach, P., Simon, B., Lanto, A., Arterburn, D., & Shekelle, P. G. (2007). Perceived barriers to weight management in primary care—perspectives of patients and providers. Journal of General Internal Medicine, 22(4), 518-522. 

Waring, M. E., Roberts, M. B., Parker, D. R., & Eaton, C. B. (2009). Documentation and management of overweight and obesity in primary care. The Journal of the American Board of Family Medicine, 22(5), 544. 

Yeh, J., & Shelton, J. A. (2005). Increasing prepregnancy body mass index: Analysis of trends and contributing variables. American Journal of Obstetrics and Gynecology, 193(6), 1994-1998.

Landmark folic acid studies

Centers for Disease Control and Prevention. (1992). Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. Morbidity and Mortality Weekly Report, 41, 1-7.

Centers for Disease Control and Prevention. (2007). Folate status in women of childbearing Age, by race/ethnicity --- United States, 1999-2000, 2001-2002, and 2004-2004. MMWR, 55(51), 1370-80.

Czeizel, A.E., & Dudas, I. (1992). Prevention of the first occurrence of neural tube defects by periconceptional vitamin supplementation. N Engl J Med, 327, 1832-5.

Elkin, A.C., & Higham, J. (2000). Folic acid supplements are more effective than increased dietary folate intake in elevating serum folate levels. BJOG, 102(2), 285-9.

Grosse, S.D., & Waitzman, N.J. (2005). Reevaluating the benefits of folic acid fortification in the United States: Economic analysis, regulation, and public health. Am J Public Health, 95, 1917-22.

Institute of Medicine, Food and Nutrition Board. (1999). Dietary reference intakes: Thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academy Press.

MRC Vitamin Study Research Group. (1991). Prevention of neural tube defects: Results of medical research council vitamin study. The Lancet, 338, 131-7.

Mulinare J., Cordeo J.F., Erickson J.D., et. al. (1988). Periconceptional use of multivitamins and the occurrence of neural tube defects. JAMA, 260,3141-5.

Smithells, R.W., Seller, M.J., Harris, R., et al. (1983). Further experiences of vitamin supplementation for prevention of neural tube defect recurrences. The Lancet, 1, 1027.

Williams, J.L., Abelman, S.M., Fassett, E.M., Stone, C.E., Petrini, J.R., Damus, K., & Mulinare, J. (2006). Health care provider knowledge and practices regarding folic acid, United States, 2002-2003. Matern Child Health J. Sep, 10(5 Suppl), S67-72.

Women’s knowledge and behavior regarding folic acid

Center for Disease Control and Prevention (2001). Are women with recent live births aware of the benefits of folic acid? Morbidity and Mortality Weekly Report, 50(06), 1-14.

Gallup Organization and March of Dimes (2008). Improving Preconception Health: Women’s Knowledge and Use of Folic Acid. 

Gallup Organization and March of Dimes (2007). Improving Preconception Health: Women’s Knowledge and Use of Folic Acid. 

Gallup Organization and March of Dimes (2005). Folic acid and the prevention of birth defects: A national survey of pre-pregnancy awareness and behavior among women of childbearing age 1995-2005.

Meyer, R.E., Wall, A., Morgan, A., et al. (2002). Knowledge and use of folic acid among North Carolina women. NC State Center for Health Statistics. NCMJ, 63(1), 18-22. 

Bentley, T.G.K., PhD, Willett, W.C., MD, DrPH, Weinstein, M.C., PhD, & Kuntz, K.M., ScD (2006). Population-level changes in folate intake by age, gender, and race/ethnicity after folic acid fortification. Am J Public Health, 96.

Pfeiffer, C.M., etc al. (2007). Trends in blood folate and vitamin B-12 concentrations in the United States, 1988–2004. Am J Clin Nutr; 86:718 –27.

Yang, Q.H., et al. (2007). Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey, 2001–2002. Am J Clin Nutr, 85, 1409–16.

Neural tube defects

Carmichael, S.L., Shaw, G.M., Neri, E., Schaffer, D.M., & Selvin, S. (2002). Physical activity and risk of neural tube defects. Matern Child Health J, 6(3), 151-7.

Carmichael, S.L., Shaw, G.M., et al. (2003). Dieting behaviors and risk of neural tube defects. Am J Epidemiol, 158, 1127–31.

Hernadez-Diaz, S., Werler, M.M., Walker, A.M., et al. (2000). Folic acid antagonists during pregnancy and the risk of birth defects. NEJM, 343, 1608-14.

Little, J., & Elwood, J.M. (1991). Epidemiology of neural tube defects. In M. Kiely (Ed.), Reproductive and perinatal epidemiology (pp. 251-336). Boca Raton:CRC Press.

Ouyang, L., Grosse, S.D., Armour, B.S., & Waitzman, N.J. (2007). Health care expenditures of children and adults with spina bifida in a privately insured U.S. population. Birth Defects Research (Part A), 79, 552-8.

Ray, J.G., Wyatt, P.R., Thompson, M.D., et al. (2007). Vitamin B12 and the risk of neural tube defects in a folic-acid-fortified population. Epidemiology, 18, 362-6.

Shaw, G.M., Velie, E.M., & Schaffer, D. (1996). Risk of neural tube defect-affected pregnancies among obese women. JAMA, 275, 1093-6.

Waller, K.D., Shaw, G.M., Rasmussen, S.A., et al. (2007). Prepregnancy obesity as a risk factor for structural birth defects. Arch Pediatr Adolesc Med, 161(8), 745-50.

Folic acid and the prevention of other birth defects

Badovinac, R.L., Werler, M.M., Williams. P., et al. (2007). Folic acid-containing supplement consumption during pregnancy and risk for oral clefts: A meta-analysis. Birth Defects Res A Clin Mol Teratol, 79(1), 8-15.

Jenkins, K.J., MD, MPH, et al. (2007). Noninherited risk factors and congenital cardiovascular defects: Current knowledge. A scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young. Endorsed by the American Academy of Pediatrics. Circulation, Vol. 115.

Wilcox, A.J., Lie, R.T., Solvoll, K., et al. (2007). Folic acid supplements and the risk of facial clefts: A national population based case-control study. BMJ, 334, 433-4.

Yazdy, M.M., Honein, M.A., & Xing, J. (2007). Reduction in orofacial clefts following folic acid fortification of the U.S. grain supply. Birth Defects Res A Clin Mol Teratol, 79(1), 16- 23.

Folic acid’s role in disease prevention

Bazzano, L.A., Jiang, H., Ogden, L.G., et al. (2002). Dietary intake of folate and risk of stroke in US men and women: NHANES I Epidemiologic Follow-Up Study Stroke. 2002 May, 33(5), 1188-9. 

Bazzano, L.A., Reynolds, K., Holder, K.N., & He, J. (2006). Effect of folic acid supplementation on risk of cardiovascular diseases: A meta-analysis of randomized controlled trials. JAMA, 296, 2720-6.

Cole, B.F., et al. (2007). Folic acid for the prevention of colorectal adenomas. JAMA, 297, 2351-9.

Fuchs, C.S., et al. (2002). The influence of folate and multivitamin use on the familial risk of colon cancer in women. Cancer Epidemiology, Biomarkers & Prevention, Vol. 11, 227-34.

Hackam, D.G., Peterson, J.C., Spence, J.D. (2000). Effects of vitamin therapy on progression of carotid atherosclerosis in patients with homocysteine levels above and below 14 micromole. L. American Journal of Hypertension.

Wang, X., Qin, X., et al. (2007). Efficacy of folic acid supplementation in stroke prevention: A meta-analysis. The Lancet, 369, 1876–82.

North Carolina research

deRosset, L., Mullenix, A., Zhang, L.Multivitamins, folic acid and birth defects: Knowledge, beliefs and behaviors of Hispanics in North Caroina. Am J Health Educ. 2009; 40(3): 155-164.

Morgan, A., Randolph, L., Meyer, R., Powers, K., & Verbiest, S. (2000). North Carolina Birth Defects Monitoring Program Surveillance Report. NC Division of Public Health. 

Morgan, L., Major, J., Meyer, R. & Mullenix, A. (2009). Multivitamin Use Among Non-Pregnant Females of Childbearing Age in the Western North Carolina Multivitamin Distribution Program. NC Med J, 70(5), 386-90.

Meyer, R., & Brown, A.B. (2004). Folic acid and birth defects prevention: A public health success story.  NC Med J, 65(3), 157-8. 

Wall, A., & Meyer, R. (2006). Birth defects in North Carolina: A report by the North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, Division of Public Health, and Department of Health and Human Services. 

Multivitamin supplements

Bodnar, L.M., Tang, G., Ness, R.B., Harger, G., & Roberts, J.M. (2006). Periconceptional multivitamin use reduces the risk of preeclampsia. Am J Epidemiol, 164(5), 470-7.

Godfrey, J.R. (2007). Toward optimal health: Meir Stampfer, M.D., Dr.P.H., discusses multivitamin and mineral supplementation for women. Journal of Women’s Health, 16(7), 959-62.

Goh, Y.I., Bollano, E., Einarson, T.R., & Koren, G. (2007). Prenatal multivitamin supplementation and rates of pediatric cancers: A meta-analysis. Clinical Pharmacology and Therapeutics, 81(5), 685-91.

Sanghvi, T., Van Ameringen, M., Baker, J., & Fiedler, J. (2007). Food and Nutrition Bulletin, 28(1 suppl). Tokyo: United Nations University Press.

Special topic publications

Preconception Care: Building the Foundation for Healthy Women, Babies, and Communities – North Carolina Medical Journal, September/October 2009

American Journal of Obstetrics and Gynecology, Volume 199, Issue 6, Supplement 2, December 2008

• Table of Contents
• Preconception care: a clinical case of "think globally, act locally"
• Where is the "W"oman in MCH?
• The clinical content of preconception care: an overview and preparation of this supplement
• Healthier women, healthier reproductive outcomes: recommendations for the routine care of all women of reproductive age
• The clinical content of preconception care: immunizations as part of preconception care
• The clinical content of preconception care: infectious diseases in preconception care
• The clinical content of preconception care: women with chronic medical conditions
• The clinical content of preconception care: women with psychiatric conditions
• The clinical content of preconception care: alcohol, tobacco, and illicit drug exposures
• The clinical content of preconception care: genetics and genomics
• The clinical content of preconception care: nutrition and dietary supplements
• The clinical content of preconception care: care of psychosocial stressors
• The clinical content of preconception care: the use of medications and supplements among women of reproductive age
• The clinical content of preconception care: reproductive history
• The clinical content of preconception care: preconception care for special populations
• The clinical content of preconception care: preconception care for men
• The clinical content of preconception care: environmental exposures
   

Women's Health Issues, Volume 18, Issue 6, December 2008

• Policy and Finance for Preconception Care: Opportunities for Today and the Future by Kay Johnson, Hani Atrash, Alison Johnson
• Marching Forward: Action Steps to Optimize the Health of Women and Babies by Jennifer L. Howse
• Transforming Preconceptional, Prenatal, and Interconceptional Care Into a Comprehensive Commitment to Women's Health by Paul H. Wise
• The Future of Preconception Care: A Clinical Perspective by Brian W. Jack, Hani Atrash, Timothy Bickmore, Kay Johnson
• Women and Health Insurance: Implications for Financing Preconception Health by Sara Rosenbaum
• Employer Approaches to Preconception Care by Kathryn E. Phillips, Georgette Flood
• Making the Most of Medicaid: Promoting the Health of Women and Infants with Preconception Care by Alina Salganicoff, Jane An
• Role of Medicaid Family Planning Waivers and Title X In Enhancing Access to Preconception Care by Rachel Benson Gold, Casey Alrich
• Community Approaches to Women's Health: Delivering Preconception Care in a Community Health Center Model by Sara Wilensky, Michelle Proser
• Healthy Start: Lessons Learned on Interconception Care by Maribeth Badura, Kay Johnson, Karen Hench, Madelyn Reyes
• Title V Strategies to Ensure a Continuum of Women’s Health Services by Helene Kent, Nan Streeter
• Translating Policy to Practice and Back Again: Implementing a Preconception Program in Delaware by Charlan Kroelinger, Deborah Ehrenthal
• Where are the Data to Drive Policy Changes for Preconception Health and Health Care? by Samuel F. Posner, Danielle L. Broussard, William M. Sappenfield, Nan Streeter, Lauren B. Zapata, Magda G. Peck
• Improving Women’s Preconceptional Health: Findings from a Randomized Trial of the Strong Healthy Women Intervention in the Central Pennsylvania Women’s Health Study by Marianne M. Hillemeier, Danielle Symons Downs, Mark E. Feinberg, Carol S. Weisman, Cynthia H. Chuang, Roxanne Parrott, Diana Velott, Lori A. Francis, Sara A. Baker, Anne-Marie Dyer, Vernon M. Chinchilli
• Welfare Reform and Insurance Coverage During the Pregnancy Period: Implications for Preconception and Interconception Care by Kosali Ilayperuma Simon, Arden Handler
• Prevalence of Chronic Illness in Pregnancy, Access to Care, and Health Care Costs: Implications for Interconception Care by Sharmila Chatterjee, Milton Kotelchuck, Usha Sambamoorthi
• The Effect of Preconception Counseling on Lifestyle and Other Behaviour Before and During Pregnancy by Joyce Elsinga, Lieke C. de Jong-Potjer, Karin M. van der Pal-de Bruin, Saskia le Cessie, Willem J.J. Assendelft, Simone E. Buitendijk

Continuing education and training

Before Between and Beyond Pregnancy - The National Preconception Curriculum and Resources for Clinicians

• CME Modules - http://www.beforeandbeyond.org/?page=cme-modules

March of Dimes Perinatal Nursing Education

• Preconception Health Promotion: A Focus for Women's Wellness

First Time Motherhood/New Parent Initiative Health Care Provider Trainings

• Reproductive Life Planning
• Folic Acid
• Health Literacy and Cultural Competency
• NC Family Planning Waiver
• Cultural Competency: Serving American Indian Patients
• Women's Mood Disorders
• Contraceptive Methods for Women with Chronic Medical Conditions
• Healthy Weight, Healthy Women

Links to more resources

• American Congress of Obstetricians and Gynecologists
• American College of Sports Medicine
• Centers for Disease Control and Prevention (CDC)
  • National Center on Birth Defects and Developmental Disabilities
  • Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion
• Eat Smart Move More North Carolina
• Every Woman Southeast
• Florida Folic Acid Coalition
• FolicAcid.net: A Guide for Health Professionals
• International Birth Defects Information Systems
• March of Dimes
  • March of Dimes North Carolina Chapter
• Maternal and Child Health Library
• National Council on Folic Acid
• National Heart, Lung and Blood Institute
• National Institutes of Health (NIH), Office of Dietary Supplements
• National Library of Medicine MedlinePlus
• National Women’s Health Resource Center
• North Carolina Birth Defects Monitoring Program 
• North Carolina Women’s Health Information Center
• Nutrition.gov
• Obesity Prevention Project
• Office of the Surgeon General – Call to Action to Prevent and Decrease Overweight and Obesity
• Spina Bifida Association of America
• The American Heart Association
• The Health Library
• UNC Center for Maternal and Infant Health
• United States Food and Drug Administration (FDA)
• Web MD
• Weight Control Information Network (NIH)

Free patient materials and resources

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