·        During the pre-conception consultation, the GP should screen and assess all risks for a future pregnancy (personal and family medical history, infections, lifestyle and work environment, medication) (evidence level 3).

·        If specific risks are present, the GP discusses these with the patient, gives advice, may possibly adjust existing therapy and, if necessary, refers the patient for specialist advice (evidence level 3).

·        GPs advise all women, preferably before pregnancy or by no later than the start of pregnancy, to stop smoking and reduce their alcohol consumption to a maximum of one unit per day (evidence level 2).

·        All women who are thinking about getting pregnant, should take a minimum daily supplement of 0.4 mg folic acid, starting from one month before pregnancy up until week 12 of pregnancy. For women at increased risk (diabetes type 1, family history of neural tube defects, carbamazepine or valproic acid intake), a dose of 4 mg per day is recommended (evidence level 1). The GP actively discusses this with women thinking about getting pregnant.

•  If the woman shows no evidence of immunity status, a blood sample is taken prior to conception for the detection of toxoplasmosis and rubella antibodies. Patients with seronegative status for rubella are vaccinated with the MMR vaccine. Patients with seronegative status for toxoplasmosis are given information on hygienic (particularly diet-related) measures (evidence level 2).