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APHA Scientific Session and Event Listing

Deborah Fromer, MPH and Linda Frazier, MD, MPH. Preventive Medicine and Public Health, University of Kansas School of Medicine, 1010 N Kansas, Wichita, KS 67214, 316-293-3567, dfromer@kumc.edu

Background: Tobacco, alcohol, pharmaceuticals and toxic substances can cause significant, permanent defects to a developing fetus. Because harmful effects can occur very early in gestation, elimination of these risk factors is recommended in the preconception period. One way to assess the standard of care relating to preconception counseling on these topics is to assess the content of medical textbooks. Methods: An audit instrument containing 106 items was created to review selected medical textbooks published between 1997-2004 for the presence or absence of preconception health information covering 15 key subject areas. Results: A total of 54 medical textbooks in 10 medical specialty categories were audited. The proportion of textbooks advising preconception counseling was 63.5% for tobacco, 69.2% for alcohol, 60.8% for pharmaceuticals and 62.0% for toxic substances. The rate of advice to counsel about alcohol in the preconception period was highest for women's health (100%, n = 4), infertility (80%, n = 5), and family medicine (70%, n = 10). Scores in this category were lowest for internal medicine (16.7%, n = 6). Conclusion: Medical textbooks cover the importance of preconceptual health but the rate of coverage varies by medical specialty. These findings suggest there are missed opportunities for textbooks to endorse and provide specific clinical recommendations about preconception counseling. More research is needed to identify ways to combine public awareness, professional education and health care policy to enhance prevention of adverse birth outcomes through risk factor reduction in the preconception period.

Learning Objectives:

• Identify risks of tobacco, alcohol and toxic substances to fertility
• List 4 harmful effects of tobacco to a developing pregnancy
• Discuss alcohol consumption guidelines before and during pregnancy

Presenting author's disclosure statement:

Not Answered