#4-58E. Optimizing Maternal and Neonatal Outcomes: The Crucial Role of Primary Care in Prepregnancy Counseling (JAMA, 2026)

Are we intervening early enough to optimize preconception health in our reproductive-aged patients? This episode reviews the article "Prepregnancy Care and Counseling A Review," which comprehensively summarizes the evidence for prepregnancy interventions with a primary care focus12. The review highlights that a significant proportion of women have modifiable risk factors and emphasizes that primary care-based discussions regarding reproductive goals, along with targeted interventions such as folic acid supplementation, immunizations, and chronic disease optimization, can significantly improve both maternal and neonatal outcomes1more_horiz. The most critical clinical takeaway is the undeniable impact of initiating these interventions early in the primary care setting to prevent severe pregnancy complications and congenital anomalies3. However, when critically appraising this review, it is important to note that some of the summarized guideline recommendations are based on low-quality studies or expert consensus, and there is a noticeable lack of randomized clinical trials5. For physicians, this paper is highly relevant as it provides practical, actionable guidelines—such as specific HbA1c targets and medication management strategies—demonstrating how to seamlessly integrate prepregnancy care into routine practice to proactively safeguard future pregnancies.

Citation: Cooper KM, Breitkopf DM. Prepregnancy Care and Counseling A Review. Journal of the American Medical Association. 2026. DOI: 10.1001/jama.2026.2888

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.