预防保健：围产期妇幼保健中缺失的一环

Preconception health:The missing link in the MNCH continuum of care

1 The need to extend and expand the maternal,neonatal and child health (MNCH) continuum to include preconception health The provision of care along the MNCH continuum is currently the core strategy for reducing maternal,neonatal and infant mortality [1-5]. Yet,gaps in the MNCH continuum persist. Reductions in maternal mortality have stagnated in many parts of the world. With the lowering of infant and child mortality,approximately 40% of infant deaths now occur in the neonatal period [6]. Strong scientific evidence indicates that improving women's health before pregnancy would result in better maternal and neonatal health outcomes-specifically,fewer pregnancy complications and a reduction in rates of birth defects,fetal loss,low birth weight and preterm delivery [7]. The WHO estimates that 19% of all maternal deaths are due indirectly to preexisting medical conditions [8]. Furthermore,early prenatal care is too late to prevent many adverse birth outcomes,as organogenesis is completed during the critical first weeks of pregnancy,often before a woman knows that she is pregnant [9]. There is a clear need to strengthen preconception health services.

1 The need to extend and expand the maternal, neonatal and child health （MNCH） continuum to include preconception health The provision of care along the MNCH continuum is currently the core strategy for reducing maternal, neonatal and infant mortality . Yet, gaps in the MNCH continuum persist. Reductions in maternal mortality have stagnated in many parts of the world. With the lowering of infant and child mortality, approximately 40% of infant deaths now occur in the neonatal period.