Priority topics for preconception care in general practice: a consensus study

Background Primary care practitioners are well-positioned to support people of reproductive age in preparing for pregnancy and parenthood. Such “preconception care” is ideally delivered opportunistically during routine consultations, although limited time presents a barrier.

Aim To achieve consensus on priority topics for opportunistic preconception care in general practice.

Design & setting A three-step consensus study involving UK-based primary care practitioners and people of reproductive age.

Method The consensus process involved: 1) identifying potential topics through literature and guideline reviews, workshops with people of reproductive age (n=15), and interviews with primary care practitioners who work in general practice (n=14); 2) prioritising topics using a Delphi survey (n=85 participants completing round one, n=63 completing all three rounds); and 3) agreeing on priority topics during an online consensus workshop (n=21 participants). Participants were recruited through a Public Advisory Group, charities, and professional organisations.

Results Reviews and workshops/interviews with people of reproductive age and practitioners identified 37 potential topics. The Delphi survey and consensus workshop identified 16 priority topics. These were combined into four overarching topic areas for discussion during relevant consultations:

1. Patient knowledge of preconception health and pregnancy

2. Ideas, concerns and expectations (e.g. pregnancy intention, prior pregnancy experiences)

3. Health conditions (e.g. medication use, mental/physical health, immunisation)

4. Health behaviours (e.g. folic acid supplement use, smoking, alcohol consumption).

Conclusion The agreed priority topic areas offer a structured foundation for delivering patient-centred, opportunistic preconception care in primary care. The findings support future co-development of practical tools and resources to enable routine implementation.