National and international guidelines for preconception care and comparison with Australian guidelines: a systematic review

BACKGROUND: Guidelines for preconception care are resources that are systematically arranged based on evidence and local contexts to enhance the delivery of high-quality and consistent healthcare. The Royal Australian College of General Practitioners Guidelines (RACGP) for preventive activities in general practice (the Red Book) contains specific components of preconception care items, yet this guideline primarily focuses on general preventive healthcare and may not include a comprehensive list of preconception items based on more recent evidence. This review aimed to compare the recent RACGP guidelines (the 2024 Red Book) with national and international guidelines for preconception care. METHODS: Electronic databases, including PubMed, Embase, Web of Science, CINAHL, and Scopus, were systematically searched following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We also searched clinical guideline registries on professional organisations' websites. Searches were conducted from May to June 2024 and in July 2025. RESULTS: We identified seven other national and international guidelines that recommended what should be done as part of preconception health in clinical practice. Preconception care elements that were not included in the current RACGP guidelines that have evidence of effectiveness were the inclusion of men in preconception care, screening for intimate partners and domestic violence, screening for chlamydia and gonorrhoea infections, and screening for female genital mutilation as part of preconception care. CONCLUSIONS: This review identified four preconception care elements that may potentially improve the implementation of preconception care in Australian practice. This work informs the next steps towards developing a comprehensive preconception medical record tool for use in general practice.