Objective  To evaluate the effect of pre-pregnancy health check for eugenics on prevention and control of adverse pregnancy outcome including birth defects in Guangdong province.

  Methods  Surveillance data on 1 953 746 childbearing couples participating in the pre-pregnancy health checkup for eugenics in various regions of Guangdong province from 2014 through 2017 were collected for a retrospective analysis.

  Results  Of all the participants surveyed during the period, 37.36% were assessed with risk factors for having abnormal fetuses. The top five identified risk factors for birth defect among the childbearing women included not taking supplemental folic acid during early pregnancy (40.28%), common reproductive tract infection (17.26%), abnormality in urine test (16.61%), abnormality of reproductive tract (14.12%), and at elder age (10.29%); while, the top three risk factors for the men at childbearing age were at elder age (17.11%), abnormality in physical examination (10.95%), and abnormality in reproductive system (9.45%). A total of 779 722 childbearing women were followed-up to their deliveries or pregnancy terminations. The incidence of total adverse pregnancy outcome was 7.10%, and the incidence of total birth defects was 15.69 per 10 000 perinatal infants.

  Conclusion  Pre-pregnancy health checkup for eugenics has significant effects on prevention and control of adverse pregnancy outcomes such as birth defects and the checkup should be carried out among childbearing couples continuously to reduce the incidence of birth defects.