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Psychosocial issues in pregnancy.

For many women, psychosocial problems may directly contribute to poor pregnancy outcome, or impede effective care for medical or obstetric problems. Prenatal care should begin with a comprehensive risk assessment and development of a plan to respond to psychosocial problems or identified risks. These efforts may be accomplished through actions the primary provider initiates or through referral or use of community services. The contribution of psychosocial risks to adverse pregnancy outcomes, approaches to risk assessment, and prevention and management strategies are described.