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首页> 外文期刊>Obstetrics and Gynecology: Journal of the American College of Obstetricians and Gynecologists >Health Care System Measures to Advance Preconception Wellness Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative
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Health Care System Measures to Advance Preconception Wellness Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative

机译：卫生系统促进孕前健康共识的措施，国家孕前健康与卫生保健计划临床工作组的建议

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Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements.
机译：孕前保健反映出受孕之前妇女的整体健康状况，以此作为影响妇女，胎儿和婴儿健康结果的策略。孕前保健很难衡量，因为它试图在怀孕前捕获健康状况，这可能会受到医疗保健系统内许多不同服务点的影响。国家孕前保健和卫生保健计划的临床工作组提出了九项核心指标，可在开始产前保健时对其进行评估，以评估女性的孕前保健状况。基于网络的两阶段修改后的德尔菲调查和妇女生殖健康领域主要舆论领袖的面对面会议确定了用于确定核心措施的七个标准。工作组就九种孕前保健措施达成共识，以作为整个卫生界对孕前保健质量的替代但可行的评估。这些指标包括：1）怀孕意向，2）获得护理，3）孕前使用叶酸的多种维生素，4）避免吸烟，5）抑郁不受控制，6）健康体重，7）没有性传播感染， 8）妊娠糖尿病妇女的最佳血糖控制，以及9）避免致畸药物。拟议措施的重点是量化卫生保健系统对促进孕前保健的影响。工作组建议卫生保健系统采用这九种孕前保健措施作为监测孕前保健实践绩效的指标。随着时间的流逝，监视这些基准度量将建立基准，并允许在区域，卫生保健系统和社区之间进行比较，以推动改善。

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