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This book chapter delves into periconceptional and prenatal care strategies targeting Great Obstetrical Syndromes (GOS), encompassing preterm birth, preeclampsia, diabetes mellitus, impaired fetal growth, and fetal/neonatal death. GOS significantly contribute to maternal and neonatal morbidity and mortality, prompting the imperative for proactive preventive measures during key reproductive health stages. Established in clinical practice post-2009, GOS constitutes a spectrum of obstetric complications influenced by lifestyle, diet, maternal aging, and environmental factors. The chapter underscores the pivotal role of periconceptional medicine and prenatal care as moments for preventive interventions, identifying pro-inflammatory processes and abnormal placentation as common origins, thereby unveiling new prevention avenues like low-dose aspirin. Addressing preterm delivery, a leading cause of infant mortality, involves early risk factor identification and patient education. Modifiable factors like nutrition, socioeconomic status, and lifestyle provide intervention opportunities, detailed in clinician-oriented tables. Regarding preeclampsia, a major cause of maternal and perinatal mortality, the chapter explores screening strategies, with aspirin demonstrating efficacy in preventing preterm preeclampsia. Lifestyle considerations, such as moderate exercise and calcium supplementation, are also highlighted. Diabetes in pregnancy risks necessitate preconception care focusing on glycemic control, family planning, and lifestyle adjustments, with gestational weight gain, HbA1C monitoring, and early gestational diabetes identification integral to prenatal care. Fetal Growth Restriction (FGR), associated with impaired placentation and pro-inflammatory mechanisms, demands early identification through preconceptional/obstetric visits. Aspirin emerges as a potential preventive measure, showing efficacy in reducing risks of preterm birth and placental abruption. Stillbirth, influenced by various causes, requires a standardized definition for global comparisons, emphasizing the need for early detection through preconceptional and prenatal care. In conclusion, the review underscores early care’s critical role in identifying high-risk pregnancies, paving the way for more effective preventive strategies and emphasizing the necessity for continued research in this field.

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Insights into Periconceptional and Prenatal Care to Prevent Great Obstetrical Syndromes

  • 章节

  • 发表日期：

    2026年

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  • Gian Carlo Di Renzo,
  • Valentina Tosto,
  • Valentina Tsibizova,
  • Graziano Clerici,
  • Arun Meyyazhagan

摘要

This book chapter delves into periconceptional and prenatal care strategies targeting Great Obstetrical Syndromes (GOS), encompassing preterm birth, preeclampsia, diabetes mellitus, impaired fetal growth, and fetal/neonatal death. GOS significantly contribute to maternal and neonatal morbidity and mortality, prompting the imperative for proactive preventive measures during key reproductive health stages. Established in clinical practice post-2009, GOS constitutes a spectrum of obstetric complications influenced by lifestyle, diet, maternal aging, and environmental factors. The chapter underscores the pivotal role of periconceptional medicine and prenatal care as moments for preventive interventions, identifying pro-inflammatory processes and abnormal placentation as common origins, thereby unveiling new prevention avenues like low-dose aspirin. Addressing preterm delivery, a leading cause of infant mortality, involves early risk factor identification and patient education. Modifiable factors like nutrition, socioeconomic status, and lifestyle provide intervention opportunities, detailed in clinician-oriented tables. Regarding preeclampsia, a major cause of maternal and perinatal mortality, the chapter explores screening strategies, with aspirin demonstrating efficacy in preventing preterm preeclampsia. Lifestyle considerations, such as moderate exercise and calcium supplementation, are also highlighted. Diabetes in pregnancy risks necessitate preconception care focusing on glycemic control, family planning, and lifestyle adjustments, with gestational weight gain, HbA1C monitoring, and early gestational diabetes identification integral to prenatal care. Fetal Growth Restriction (FGR), associated with impaired placentation and pro-inflammatory mechanisms, demands early identification through preconceptional/obstetric visits. Aspirin emerges as a potential preventive measure, showing efficacy in reducing risks of preterm birth and placental abruption. Stillbirth, influenced by various causes, requires a standardized definition for global comparisons, emphasizing the need for early detection through preconceptional and prenatal care. In conclusion, the review underscores early care’s critical role in identifying high-risk pregnancies, paving the way for more effective preventive strategies and emphasizing the necessity for continued research in this field.