BACKGROUND:
The importance of preconception care(PCC) in improving maternal health is becoming more widely acknowledged. Preconception preparation may prevent or reduce the risk of adverse birth outcomes through appropriate management and preventive measures.

OBJECTIVES:
The objectives of the study were i) to determine the effect of preconception care intervention in improving maternal nutritional status and reduce the risk of adverse birth outcomes ii) to investigate the relationship of birth outcomes with both maternal and paternal preconception health.

METHODS:
A non-randomized control trial was conducted in two rural community areas for comparing two interventions: preconception care with standard maternal health care (MHC) program(Integrated PCC) and standard MHC program (without PCC) among married women in the reproductive age group 18-35 years who were desiring to have a child. The study enrolled total 673 women through probability proportional to size sampling technique. The study group received integrated preconception care which included maternal screening, supplementation with folic acid and iron, contraceptive counseling, vaccination, and lifestyle modification.

RESULTS:
Women who had received PCC had 28.7% less risk of developing anemia during pregnancy, 60% less risk of giving birth to low birth weight babies and 16.8% less risk of undergoing preterm delivery. The rate of caesarean delivery was significantly reduced by 27% among the women who had received PCC (p<0.05). Maternal preconception diabetes status and hypertension was associated with heavier infants and preterm births respectively, whereas paternal diabetes was associated with low birth weight infants (p<0.05).

CONCLUSIONS:
The preconception care intervention had a significant impact on enhancing maternal nutritional status especially prevention of anemia, reducing burden of low birth weight babies, preterm birth, cesarean delivery, maternal and neonatal complications.

KEY MESSAGE:
The preconception care can be integrated with standard maternal health care for preventing adverse pregnancy outcomes for which training and routine practices must be incorporated by the midwives and primary care physicians. SRHR - Preconception/contraception (including three-minute presentation competition)