Introduction 1 2 Materials and methods A MEDLINE search with English language and human subject restriction was conducted for the years 1980 through May 9, 2005 using the reference terms “preconception (pre-conception) care,” “preconception counseling,” “preconceptional care,” “periconception care,” and “periconceptional care.” A total of 756 citations were identified using the initial search parameters. References for which preconception care programs or activities outside of the United States comprised the primary topic of interest were included. Articles detailing clinical or scientific evidence of specific periconceptional interventions were excluded. Also reviewed were other published articles as well as textbook chapters, declarations, reports, and recommendations not retrievable from these databases. The search terms were also entered in various internet search engines and relevant web-based information was used to supplement the findings. Pertinent abstracts from the National Summit on Preconception Care (CDC, June 2005) were also reviewed. Results A total of 42 articles, book chapters, declarations, and other published materials were reviewed. The findings were categorized into three main areas in order to present the material in a coherent fashion: international conferences and accords, professional organizations, and international preconception care programs. International conferences and accords 2 4 3 5 6 7 5 8 3 3 9 3 5 9 10 11 3 12 13 14 Professional organizations and associations 3 15 3 16 17 17 3 18 International preconception care guidelines and programs 19 1 20 21 22 23 24 25 26 25 27 27 28 29 30 31 32 33 33 1 23 24 34 35 36 37 38 38 39 40 40 41 41 Conclusions World Health Report 2005: Make Every Mother and Child Count 42 43 45 The present description of international programs and perspectives on preconception care is limited in scope by numerous factors. The literature search was as comprehensive as possible but not exhaustive because of language restrictions, difficulty in retrieving documentation of international preconception care programs and policies, the relative scarcity of published information about international preconception care practices, and the myriad of maternal and child health outcomes that fall under the umbrella of preconception health and for which both population-based and targeted interventions exist. Finally, data pertaining to maternal and infant outcomes after the introduction of preconception care activities is often unavailable. Thus, this review provides only a broad overview of international activities related to preconception health. However, the findings are instructive as a preliminary step in the compilation and dissemination of information related to international preconception care recommendations and practices. Future research should include a regionalized inspection and comparison of preconception care programs, policies, and recommendations within and among various countries. The impact of these programs on community-specific indicators of maternal and perinatal health should also be evaluated. 43 47 48