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Interconception care by child's physician provides reduction of maternal risk factors

Family physicians providing interconception care to mothers at their child’s regular doctor visits can lead to better health outcomes for mothers, children, and newborns, according to a recent study.

“[Interconception care] has been broadly advocated but not widely implemented,” Stephanie E. Rosener, MD, from the Middlesex Hospital Family Medicine Residency Program and colleagues wrote. “The purpose of this study was to investigate [interconception care] practices by family physicians at well-child visits. We focused on maternal depression, tobacco use, folic acid supplementation, and family planning because of the strength of evidence for addressing these factors when aiming to reduce poor birth outcomes.”

The researchers assessed a convenience sample at family medicine academic practices in the IMPLICIT (Interventions to Minimize Preterm and Low Birth Weight Infants Through Continuous Improvement Techniques) Network of mothers escorting their child to regular doctor visits. Rosener and colleagues evaluated maternal receptiveness to advice from the physician along with behaviors, health history, and how frequently the child’s physician addressed maternal depression, family planning, tobacco use, and folic acid supplementation.

Of the 658 participants, 75% shared a medical home with their child. In total, 17% had a prior preterm birth, 19% had a history of depression, 26% were not using contraception, 25% were smoking, and 58% were not taking folic acid. Among the mothers who were offered advice from their child’s physicians, 80% who smoked were encouraged to quit, 59% reported depression screening, 71% talked about contraception, and 44% discussed folic acid. The researchers found that when a mother and child shared a medical home, screening for depression and family planning were more likely (P < .05). Notably, almost 95% of mothers willingly accepted health advice from their child’s physician regardless of whether they shared a medical home (P > .05).

“A brief, standardized [interconception care] model could hasten widespread implementation,” Rosener and colleagues wrote. “All pediatric care clinicians should be educated about the potential benefits of [interconception care], the challenge of reaching mothers during the interconception period, and the high maternal acceptability of receiving personal health advice at well-child visits.”—by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.