Feasibility and effectiveness of preconception check-ups at workplaces in Japan

Abstract

Objectives: Despite the recent increase in infertility and perinatal complications, preconception care is not commonly available in Japan. Working women are considered to have the greatest need for preconception care, as increasingly they marry and have children later in life. This study aimed to assess the feasibility and effectiveness of preconception check-ups in the workplace.

Methods: We provided 51 female employees aged 18-39 years with free preconception check-ups, including additional blood tests and an online medical questionnaire, during mandatory health check-ups at their workplace. A doctor provided online counseling based on the check-up results. We assessed fertility knowledge using the Cardiff Fertility Knowledge Scale (CFKS-J) and childbearing desire pre- and postintervention.

Results: Preconception check-ups revealed various potential risk factors for future pregnancies, including underweight (12%), obesity (20%), Chlamydia trachomatis IgG antibody positivity (22%), low rubella IgG antibody levels (47%), iron deficiency (12%), and 25-hydroxyvitamin D levels <30 ng/mL (98%). Postintervention, the participants reported high satisfaction with the check-ups and significantly advanced their reproductive plans (P = .008). Furthermore, 95% of the participants indicated an intention to seek medical attention or make lifestyle changes. The postintervention CFKS-J score (mean [SD]) was higher than the preintervention score (71.7 [19.3] vs 63.0 [22.0]; P = .006).

Conclusions: We developed a preconception check-up package that can be integrated into workplace health examinations, complemented by tailored counseling. This novel check-up package is a feasible and effective approach for improving preconception health and fertility awareness.

Keywords: feasibility studies; preconception care; reproductive health service; women’s health.

Figure 1

Collaborative framework of the preconception check-up package managed by a nonprofit organization. The figure depicts the flow of the preconception check-ups. (1) Nonprofit organization (NPO) provides information to the company and its employees. (2) Those wishing to participate apply directly to the NPO and (3) complete a questionnaire. (4) The NPO coordinates the schedule with the medical examination provider. (5) Participants undergo preconception check-ups at the same time as the staff medical examination. (6) The results of the medical examination are sent directly to Akita University. (7) The NPO shares the data of the examinees, including the questionnaire contents, with Akita University. (8) Akita University conducts online counseling based on the medical examination and questionnaire results.

Figure 2

T1-T3 changes in fertility knowledge and childbearing desires (n = 41). A, Comparison of the Japanese version of the Cardiff Fertility Knowledge Scale (CFKS-J) scores pre- and postintervention. Pre- and postintervention mean (95% CI) scores on the CFKS-J are shown. The preconception check-up package intervention significantly improved the score from 63.0 (56.1-70.0) to 71.7 (65.6-77.8) percentage points (P = .006, paired t tests). B, Desired number of additional children. Pre- and postintervention distributions are shown and compared using the Wilcoxon signed rank test. C, Plan to try conceiving. Pre- and postintervention distributions are shown and compared using the Wilcoxon signed rank test. Those who desired ≥1 child were included (n = 32).