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GP-initiated preconception counselling in a randomised controlled trial does not induce anxiety

Author: Jong-Potjer, L.C. de · Elsinga, J. · Cessie, S. le · Pal-de Bruin, K.M. van der · Knuistingh Neven, A. · Buitendijk, S.E. · Assendelft, W.J.J.
Type:article
Date:2006
Institution: TNO Kwaliteit van Leven
Source:BMC Family Practice, 7
Identifier: 239582
doi: doi:10.1186/1471-2296-7-66
Article number: No.: 66
Keywords: Health · Clinical trial · Controlled clinical trial · Controlled study · First trimester pregnancy · General practice · General practitioner · Human experiment · Maternal care · Netherlands · Population · Pregnancy outcome · State Trait Anxiety Inventory · Confidence interval · Family planning · Methodology · Pregnant woman · Psychological aspect · Psychometry · Randomized controlled trial · Adolescent · Adult · Anxiety · Confidence Intervals · Counseling · Family Planning Services · Family Practice · Female · Humans · Netherlands · Personality Tests · Preconception Care · Pregnancy · Pregnancy Complications · Pregnancy Trimester, First · Pregnant Women · Psychometrics · Risk Assessment · Risk Factors

Abstract

Background: Preconception counselling (PCC) can reduce adverse pregnancy outcome by addressing risk factors prior to pregnancy. This study explores whether anxiety is induced in women either by the offer of PCC or by participation with GP-initiated PCC. Methods: Randomised trial of usual care versus GP-initiated PCC for women aged 18-40, in 54 GP practices in the Netherlands. Women completed the six-item Spielberger State Trait Anxiety Inventory (STAI) before PCC (STAI-1) and after (STAI-2). After pregnancy women completed a STAI focusing on the first trimester of pregnancy (STAI-3). Results: The mean STAI-1-score (n = 466) was 36.4 (95% CI 35.4 - 37.3). Following PCC there was an average decrease of 3.6 points in anxiety-levels (95% CI, 2.4 - 4.8). Mean scores of the STAI-3 were 38.5 (95% CI 37.7 - 39.3) in the control group (n = 1090) and 38.7 (95% CI 37.9 - 39.5) in the intervention group (n = 1186). Conclusion: PCC from one's own GP reduced anxiety after participation, without leading to an increase in anxiety among the intervention group during pregnancy. We therefore conclude that GPs can offer PCC to the general population without fear of causing anxiety. © 2006 de Jong-Potjer et al; licensee BioMed Central Ltd.