Background Primary care practitioners are well-positioned to support people of reproductive age in preparing for pregnancy and parenthood. Such “preconception care” is ideally delivered opportunistically during routine consultations, although limited time presents a barrier.

Aim To achieve consensus on priority topics for opportunistic preconception care in general practice.

Design and setting A three-step consensus study involving UK-based primary care practitioners and people of reproductive age.

Method The consensus process involved: 1) identifying potential topics through literature and guideline reviews, workshops with people of reproductive age (n=15), and interviews with primary care practitioners who work in general practice (n=14); 2) prioritising topics using a Delphi survey (n=85 participants completing round one, n=63 completing all three rounds); and 3) agreeing on priority topics during an online consensus workshop (n=21 participants). Participants were recruited through a Public Advisory Group, charities, and professional organisations.

Results Reviews and workshops/interviews with people of reproductive age and practitioners identified 37 potential topics. The Delphi survey and consensus workshop identified 16 priority topics. These were combined into four overarching topic areas for discussion during relevant consultations:

Patient knowledge of preconception health and pregnancy

Ideas, concerns and expectations (e.g. pregnancy intention, prior pregnancy experiences)

Health conditions (e.g. medication use, mental/physical health, immunisation)

Health behaviours (e.g. folic acid supplement use, smoking, alcohol consumption).

Conclusion The agreed priority topic areas offer a structured foundation for delivering patient-centred, opportunistic preconception care in primary care. The findings support future co-development of practical tools and resources to enable routine implementation.

How this fits in Preconception care improves pregnancy outcomes, but in UK general practice it is inconsistently delivered, partly due to limited time and guidance that offers little prioritisation for opportunistic consultations. This study identifies four overarching topic areas for preconception care, based on consensus among people of reproductive age and primary care practitioners. The resulting priority list offers clinicians a practical, flexible way to initiate patient-centred preconception care discussions within routine consultations.

The authors have declared no competing interest.

This study was funded through a National Institute for Health and Care Research (NIHR) Advanced Fellowship (NIHR302955) awarded to DS. DS is also supported by the NIHR Southampton Biomedical Research Centre (NIHR203319). KMG is supported by the UK Medical Research Council (MC_UU_12011/4), the NIHR (NIHR Senior Investigator (NF-SI-0515-10042) and NIHR Southampton Biomedical Research Centre (NIHR203319)) and Alzheimers Research UK (ARUK-PG2022A-008). EL is supported by an NIHR In Practice Fellowship (NIHR303515). KMS is supported by a Health Research Board Emerging Investigating Award (HBB-EIA-2022-005).

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The University of Southampton Faculty of Medicine Ethics Committee gave ethical approval for this work (ERGO 83699 and 92950).

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All data produced in the present study are available upon reasonable request to the authors.