Keywords
Peri-conception care; Pre conception care; Pre-pregnancy care; Medical conditions; Realist review
Abstract
Women with pre-existing medical conditions are at increased risk of complications during pregnancy that can affect the immediate and long-term health of themselves and their offspring. Evidence suggests that preparation in the peri-conception period, before and during very early pregnancy, is effective but not all women are aware of, or able to undertake, the advised condition-specific behaviour change prior to pregnancy. Improving outcomes for these women requires a greater understanding of what approaches work, for whom they work, in what context and how. This protocol outlines how realist review methods can be used to synthesize evidence on peri-conception care for women with pre-existing medical conditions. The review will be conducted in two phases using electronic database and supplementary searching to find relevant evidence to develop and test program theories about how peri-conception care works. Phase 1 will focus on initial theory development, specifically the context and mechanisms that may explain how it works. Phase 2 will then be undertaken to test and refine these program theories. Experts and women with relevant lived experience will be consulted at each phase of the review to ensure it is grounded in real-life. The findings will be disseminated locally, nationally and internationally to peri-conception care networks. This realist review will explore how and for whom peri-conception care works, in order to support decisions regarding how to implement effective peri-conception care for women with pre existing medical conditions and thus improve the lives of affected families. The findings will also inform a realist evaluation of peri-conception care, with the aim to further refine program theory and explore different methods of implementation of peri-conception care.
Citation
Heather Hopper, Kerryn Husk, Bridie Kent, Amanda Wanner and Jill Shawe. What Approaches to Peri-Conception Care for Women with Pre-Existing Medical Conditions Work, for Whom and in What Circumstances? A Protocol for A Realist Review. SM J Gynecol Obstet. 2018; 4(1): 1029.