Preconception Health Behaviors Research Articles

Factors associated with clinical nurses' preconception health behavior in Korea: a cross-sectional survey.

Nurses have been reported to be at an increased risk for miscarriage and preterm labor. However, there is limited knowledge regarding nurses' preconception health behaviors. Therefore, this study aimed to identify factors influencing these behaviors. One hundred sixty nurses, who were planning their first pregnancy within the upcoming year, participated in an online survey from August 11 to October 31, 2021. Data on preconception health behavior, perceived health status, pregnancy anxiety, nursing practice environment, and social support were analyzed using the t-test, Pearson correlation coefficients, and multiple regression analysis. Age (р=.024), educational level (р=.010), marital status (р=.003), work experience (р=.003), satisfaction with the work department (р<.001), smoking status (р=. 039), and previous health problems related to pregnancy outcomes (р=.004) were significantly associated with nurses' preconception health behaviors. Furthermore, perceived health status (р<.001), pregnancy anxiety (р=.011), nursing practice environment (р=.003), and social support (р<.001) showed significant correlations with preconception health behaviors. Social support (β=. 28, р=.001), satisfaction with the work department (β=.23, р=.032), marital status (β=.22, р=.002), and perceived health status (β=.23, р=.002) were confirmed as factors associated with preconception health behaviors. These factors explained 40.9% of the variance in preconception health behaviors (F=6.64, р<.001). Clinical nurses' preconception health behaviors were influenced by social support, perceived health status, satisfaction with the work department, and marital status. Interventions to improve clinical nurses' preconception health behaviors should target social support and perceived health status. A preconception health behavior education program considering clinical nurses' marital status and satisfaction with the workplace can also be implemented.

Evaluating preconception health and behaviour change following a digital intervention: OptimalMe

Abstract Background Reproductive-aged women are a high-risk group for accelerated weight gain and obesity development. The objective of the current study was to assess the impact of a digital healthy lifestyle intervention for women planning a pregnancy, in optimising preconception health and lifestyle behaviours. Methods Australian women with the intention to conceive were invited to participate in OptimalMe. To be eligible women must be aged 18-44 years, not pregnant but wanting to conceive within 12 months of recruitment and have internet access. All participants receive the same digital lifestyle intervention, supported by health coaching and text messages during preconception. A parallel 2-arm design with sequential randomisation to compare telephone with videoconference delivery methods for health coaching was adopted. Results Overall, 298 women enrolled, with a mean ± (SD) age of 31.7 (4.6) years and BMI 25.5 (6.3) kg/m2. Suboptimal preconception behaviours were reported at baseline including alcohol consumption (57.0%), infrequent weighing (37.2%), and incomplete cervical cancer screening (15.8%) and prenatal supplementation (38.6%). The OptimalMe evaluation was completed by 217 women, 72.8% of the study population, an average of 4.5 months after commencing the intervention. At follow-up, a significant shift towards desired behaviours was reported for alcohol consumption (non-drinker) (z = 2.727, p = 0.00634), prenatal supplementation (taking supplement) (z=-11.082, p &amp;lt; 0.00001) and weighing behaviour (frequent weigher) (z=-5.291, p &amp;lt; 0.00001). Conclusions Results indicate that women who are actively planning a pregnancy require support to optimise health and lifestyle in preparation for pregnancy. Post intervention outcomes suggest that remotely delivered preconception interventions improve lifestyle behaviours and engagement with clinical preconception care objectives. Key messages • Digital health interventions show positive change to important lifestyle behaviours. • Women planning a pregnancy demonstrate sub optional health and lifestyle behaviours therefore interventions are needed to improve this.

Exploring Health Behaviours, Attitudes and Beliefs of Women and Men during the Preconception and Interconception Periods: A Cross-Sectional Study of Adults on the Island of Ireland.

Preconception health is increasingly seen as a key target for improving population health in the UK and Ireland, yet little is known about the attitudes and beliefs of adults regarding preconception care strategies. This online cross-sectional survey aimed to explore the health behaviours, attitudes and beliefs of adults of reproductive age in regard to preconception health and care. The survey was developed by reviewing the previous literature and engaging with those from the target group. It is one of the first surveys to assess the attitudes and beliefs of adults of reproductive age across the Island of Ireland regarding preconception health and care. Results from 386 individuals with a mean age of 29.9 ± 10.3 years were included. A variety of health behaviours, attitudes and beliefs were investigated, with differences being identified between women and men and between participants with or without children (i.e., in the preconception or interconception stage). The majority of respondents held beliefs that preconception care was important, but there was greater emphasis on women than men in terms of the need to engage in health-promoting preconception health behaviours. This study highlights the need to improve preconception health awareness in women and men in the preconception and interconception stage. Findings indicate that efforts to improve preparation for pregnancy among adults of childbearing age are needed, to ensure optimal engagement in preconception health behaviours, with efforts being tailored based on sex and parental status.

The Effect of Preconception Counseling According to the Theory of Planned Behavior with the Presence of the Spouse on Preconception Health Behaviors – A Training Trial Study

Background and Objective: Preconception care consists of biomedical, behavioral, and social services, along with health interventions, for women and couples before conception to improve their health status and reduce individual and environmental high-risk behaviors. This study aimed to assess to preconception counseling according to the theory of planned behavior with the presence of the spouse on preconception care behaviors. method: This study was an educational trial. The researcher randomly divided women into two intervention and control groups. The control group only received routine preconception care with the presence of the spouse. The intervention group according to the theory of planned behavior received the 60-minute face-to-face and group counseling weekly sessions. Outcomes of behavior were divided into two categories, including screening tests and vaccinations, and individual lifestyle (exercise, nutrition, and smoking). The questions also focused on men’s check-up tests. Data were analyzed using independent t-tests, chi-square, repeated measures test, and SPSS 26 software. result: The lifestyle behaviors score indicating no significant differences Between two groups (p=0.08). However, the two groups had a significant increase in healthy lifestyles over time, including nutrition and exercise. The results also showed that the mean of test and vaccination indicating no significant differences too. conclusion: Since the presence of the husband during the training of women's pre-pregnancy care can affect their health behaviors regardless of the type of intervention, men are suggested to attend pre-pregnancy training and consultations for at least one session.

Corrigendum: Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea

Corrigendum: Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea

Paternal preconception modifiable risk factors for adverse pregnancy and offspring outcomes: a review of contemporary evidence from observational studies

BackgroundThe preconception period represents transgenerational opportunities to optimize modifiable risk factors associated with both short and long-term adverse health outcomes for women, men, and children. As such, preconception care is recommended to couples during this time to enable them to optimise their health in preparation for pregnancy. Historically, preconception research predominately focuses on maternal modifiable risks and health behaviours associated with pregnancy and offspring outcomes; limited attention has been given to inform paternal preconception health risks and outcomes. This systematic review aims to advance paternal preconception research by synthesising the current evidence on modifiable paternal preconception health behaviours and risk factors to identify associations with pregnancy and/or offspring outcomes.MethodsMedline, Embase, Maternity and Infant care, CINAHL, PsycINFO, Scopus, and ISI Proceedings were searched on the 5th of January 2023, a date limit was set [2012–2023] in each database. A Google Scholar search was also conducted identifying all other relevant papers. Studies were included if they were observational, reporting associations of modifiable risk factors in the preconception period among males (e.g., identified as reproductive partners of pregnant women and/or fathers of offspring for which outcomes were reported) with adverse pregnancy and offspring outcomes. Study quality was assessed using the Newcastle–Ottawa Scale. Exposure and outcome heterogeneity precluded meta-analysis, and results were summarised in tables.ResultsThis review identified 56 cohort and nine case control studies. Studies reported on a range of risk factors and/or health behaviours including paternal body composition (n = 25), alcohol intake (n = 6), cannabis use (n = 5), physical activity (n = 2), smoking (n = 20), stress (n = 3) and nutrition (n = 13). Outcomes included fecundability, IVF/ISCI live birth, offspring weight, body composition/BMI, asthma, lung function, leukemia, preterm birth, and behavioural issues. Despite the limited number of studies and substantial heterogeneity in reporting, results of studies assessed as good quality showed that paternal smoking may increase the risk of birth defects and higher paternal BMI was associated with higher offspring birthweight.ConclusionThe current evidence demonstrates a role of paternal preconception health in influencing outcomes related to pregnancy success and offspring health. The evidence is however limited and heterogenous, and further high-quality research is needed to inform clinical preconception care guidelines to support men and couples to prepare for a health pregnancy and child.

Predictors of preconception health knowledge among Canadian women: A nationwide cross-sectional study.

Optimising preconception health-that is the health of women and men prior to a potential pregnancy-is increasingly recognised as fundamental to improving maternal and infant health outcomes. To date, limited research has been conducted examining preconception knowledge and studies focusing on preconception health behaviours have targeted certain behaviours, while overlooking others, with limited attention given to the interconception period and differences between multiparous and primiparous/nulliparous women. To determine predictors of preconception health knowledge among Canadian women and to examine whether parity modified the effect of predictors on preconception knowledge. A cross-sectional study reported according to STROBE was undertaken from May to June 2019 in Canada with 928 women. An online questionnaire was used including the Preconception Health Knowledge Questionnaire, demographic characteristics, current health status, previous pregnancy outcomes and use of preconception care services. Ordinary least squares regression was used to model knowledge scores. Predictors were entered using theoretically driven hierarchical entry. Mean age of women was 34 years and one in five were immigrants. In the final model, household income (b=.17, SE=.07; p=.009), being born outside Canada (b=-.75, SE=.25; p=.003), miscarriage/stillbirth history (b=.47, SE=.21; p=.027) and previous use of preconception care (b=.97, SE=.20, p ⟩ .001) were predictive of preconception health knowledge. Effect modification by parity was not statistically significant in the final model (f=1.22, p=.19). Women at higher risk of poor preconception knowledge, and who therefore stand to gain from preconception knowledge interventions may include those who (1) are socially and economically disadvantaged; (2) have not engaged in preconception care previously and (3) were not born in Canada. Ensuring national promotion of and access to preconception care is an important strategy to prevent adverse pregnancy outcomes and optimise maternal and infant health. This study highlights the need for national promotion of and access to preconception health care for all pregnancy-planning families in order to improve perinatal outcomes. When evaluating preconception health efforts, preconception health knowledge must be considered within the context of social determinants of health and individuals' abilities to act on their knowledge.

The intergenerational effects of parental physical activity on offspring brain and cognitive development: a scoping review

Introduction: Maternal preconception and prenatal health behaviours (e.g., diet, alcohol consumption, smoking, etc.) impact offspring neurodevelopment. Physical activity (PA) has been linked to improved maternal health during preconception, pregnancy, and postpartum and reduced risk of pregnancy complications. PA not only helps to improve physical health but can also enhance brain health and cognition across the lifespan. Accumulating evidence in animal models suggests PA also has intergenerational effects on brain health and development.

The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study

PurposePregnancy intentions are associated with preconception health behaviors but are understudied among female adolescent and young adult (AYA) cancer survivors. Preconception health is critical for survivors because they face unique risks to fertility and pregnancy from late effects of cancer treatments. This study prospectively assessed the effect of pregnancy intention on physical activity (PA) and smoking behaviors among female AYA survivors.MethodsA cohort of 1049 female AYA survivors were recruited between 2013 and 2017. Participants were 18–39 years and had completed primary cancer treatment. Longitudinal mixed effects analysis was conducted on participants who completed at least 2 of 4 questionnaires over 1.5 years. Two measures were used to capture multiple dimensions of pregnancy intention. The pregnancy intention score (PIS) captured wanting and planning dimensions and represented a scaled response of low to high intention. The trying dimension captured urgent intention and ranged from not trying, ambivalent (neither attempting nor avoiding pregnancy), and trying now. Intention change was assessed between each consecutive time points. Final analysis was conducted with multiple imputations.ResultsSurvivors with increased intention measured by trying was associated with increased PA over time (adjusted B [95%CI]: 0.3 [0.01, 0.5]) compared to survivors with no changes or decreased trying intention. PIS was not significantly associated with preconception behaviors. No measure of intention was associated with smoking behavior.ConclusionsIncreasingly urgent pregnancy intention (trying dimension) was associated with higher preconception PA.Implications for cancer survivorsScreening for immediate intentions can identify AYA survivors in need of early preconception health promotion.

Preconception health behaviours of women planning a Pregnancy: A scale development study

ObjectivesThis study aims to develop a health behaviour scale for the preconception period and assess the preconception health behaviours of women who have applied to the municipality for marriage and are planning a pregnancy within a year. MethodThis is a methodological and descriptive study. While the exploratory and confirmatory factor analysis, the test-retest method and Cronbach’s alpha internal consistency methods were used for data analysis in the methodological stage. The Mann-Whitney U test and Kruskal-Wallis test were used in the descriptive stage. Statistical significance was accepted as p < 0.05. In total, 260 women were enrolled in the study during the scale development stage. Upon completion of the scale development stage, for the evaluation of preconception health behaviours was conducted with 331 women who were planning pregnancy within one year. ResultsThe Preconception Health Behaviours Scale consists of 18 items and 4 subscales. The Cronbach’s alpha value was 0.867. The subscales “Preparation”, “Coping Skills”, “High-Risk Behaviours” and “Nutrition and Sleep” were found to be reliable. The mean score obtained from the scale was 29.50 ± 6.57. It was determined that level of education and level of knowledge on preconception care affected the preconception health behaviours of the women who have applied for marriage. ConclusionThe Preconception Health Behaviours Scale is valid and highly reliable. Furthermore, a high level of education and high knowledge on preconception care affect preconception health behaviours positively.

Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review.

Parental health before conception effects maternal and offspring health outcomes. Preconception care provides healthcare to prospective parents addressing modifiable preconception risks and health behaviors. This umbrella review aimed to consolidate evidence on women's and men's modifiable preconception risks or health behaviors associated with maternal and offspring health outcomes. MEDLINE, EMBASE, Maternity and Infant Care, CINAHL, and PsycINFO were searched from March 4, 2010, to March 4, 2020. Eligible studies were systematic reviews or meta-analyses of observational studies examining associations between modifiable preconception risks or health behaviors and maternal and offspring health outcomes. Screening, data extraction, and methodological quality assessment (AMSTAR 2) occurred independently by two reviewers. Degree of overlap was examined. Findings were summarized for evidence synthesis. Twenty-seven systematic reviews were included. Modifiable preconception risks and health behaviors were identified across categories: body composition (e.g., overweight, obesity), lifestyle behaviors (e.g., caffeine, smoking), nutrition (e.g., micronutrients), environmental exposures (e.g., radiation), and birth spacing (e.g., short interpregnancy intervals). Outcomes associated with exposures affected embryo (e.g., embryonic growth), maternal (e.g., gestational diabetes mellitus), fetal/neonate (e.g., preterm birth), and child (e.g., neurocognitive disorders) health. For real-world practice and policy relevance, evidence-based indicators for preconception care should include body composition, lifestyle, nutrition, environmental, and birth spacing.

A Network Analysis of Multiple Preconception Health Behaviors in Chinese Women.

A healthy preconception lifestyle, consisting of multiple health behaviors, is crucial for preventing adverse health outcomes in mothers and offspring. Although knowledge about the pattern of inter-behavior relations may provide insights for nudging multiple health behavior changes, this has not been adequately explored in the existing literature. Adopting a network perspective, the present study conceptualized multiple health behaviors as a behavior network (i.e., behaviors as nodes, inter-behavior relations as edges) and utilized network analysis to investigate the pattern of interrelations of preconception health behaviors in a large sample of Chinese women. We used the data of a population-based cohort study in China to estimate the behavior network. An analytic sample included 41,127 Chinese women who were surveyed about their adoptions of multiple health behaviors during the preconception period. Network analysis revealed a relatively dense behavior network and visualized the network structure of multiple preconception health behaviors. Subsequent centrality analysis identified three central behaviors (i.e., avoiding second- or third-hand smoke, reducing psychosocial stress, and reducing alcohol) that had distinctively stronger connections to other behaviors. Preconception health behaviors were strongly interconnected, and certain behaviors had stronger influences than others within the behavior network. Our findings highlight the strong inter-relatedness of preconception health behaviors. This study also encourages targeting the three central behaviors in preconception lifestyle promotions because this may bring more secondary improvements on other non-targeted behaviors and thereby achieve comprehensive lifestyle change.

Empowering Village Health Workers to Influence Preconception Behavior and Increase Utilization of Preconception Health Services in the Deli Serdang Regency

BACKGROUND: Preconception health care are critical in addressing modifiable risk factors to prevent maternal death, neonatal death, unplanned pregnancies, birth defects, premature birth and retardation of fetal growth in the womb.&#x0D; AIM: The aim of this study was to determine the impact of preconception health cadres empowerment on changed in preconception health behaviors of brides and grooms-to-be, as well as improved utilization of preconception health services at eight community health centers in the Deli Serdang district.&#x0D; METHODS: This research is part of a dissertation study entitled Preconception Period Service Strategy on Brides and Grooms-to-Be through Empowerment of Preconception Health Cadres in Deli Serdang Regency. The effect of the empowerment of preconception health cadres in preconception health behaviors performed by Wilcoxon Signed Rank Test with the statistical significance test with CI 95% and significant difference value p&lt;0,05. The Normalized Gain (N-gain score) test is used to assess the effectiveness of the intervention.&#x0D; RESULTS. There is a significant influence of preconception health cadres empowerment interventions on the knowledge, attitudes, and actions of brides and grooms-to-be in preconception health with the same probability value of p=0.001. Most brides and grooms-to-be (80%) take advantage of preconception health services at health centers after following the intervention of empowerment of preconception health cadres.&#x0D; CONCLUSIONS. Interventions empowering preconception health cadres significantly affect the behavior of the brides and grooms-to-be and quite effective in increasing knowledge and actions of brides and grooms-to-be in preconception health.

Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea

Educational Status and Needs of Premature Birth Prevention and Its Association with Preconception Health Behavior among Women of Childbearing Age in Korea

The Relationship Between Paternal Preconception Obesity and Health Behaviors and Childhood Obesity: Protocol for a Systematic Review.

BackgroundChildhood obesity is a global public health concern and is a priority for researchers and policy makers. To overcome the epidemic of obesity, influencing factors throughout the life span need to be addressed, including those in the preconception period. A better understanding of the association between paternal preconception factors and childhood obesity is important for public health interventions.ObjectiveThis systematic review will examine the relationship between paternal preconception obesity and health behaviors and their offspring’s overweight or obesity.MethodsPeer-reviewed quantitative studies and grey literature that report associations between paternal preconception obesity and health behaviors—such as smoking, exercise, and eating habits—and childhood overweight and obesity will be identified through a computerized literature search in 7 databases. The quality of each study will be assessed using the Quality Assessment Tool for Quantitative Studies. Characteristics of the included studies will be reported, and relevant findings from each paternal preconception exposure will be narratively synthesized. This review will follow the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) 2020 guidelines.ResultsThis systematic review is anticipated to begin in December 2021 and be completed by the end of August 2022.ConclusionsThis systematic review will contribute to a better understanding of the relationship between preconception paternal exposures and their offspring’s overweight or obesity. Findings will help support health professionals working with prospective parents to educate fathers on the benefits of improving their weight and health behaviors during the preconception period.International Registered Report Identifier (IRRID)PRR1-10.2196/31254

Pre-pregnancy Health Behaviors and Gestational Weight Gain Among Hispanic/Latino Women: Hispanic Community Health Study/Study of Latinos.

To examine the association between preconception diet quality, sedentary behavior, and physical activity with gestational weight gain (GWG) among Hispanic/Latina women. This was a retrospective cohort study of participants from visits 1 and 2 of the Hispanic Community Health Study/Study of Latinos and singleton pregnancies between the 2 visits. Diet quality (alternative healthy eating index/AHEI-2010), sedentary behaviors, and physical activity (global physical activity questionnaire) were measured at visit 1 and accounted for preconception health behaviors. GWG was evaluated as a continuous and categorical variable according to the 2009 Institute of Medicine guidelines (inadequate, adequate, excessive). Linear and generalized logit survey regressions were used to study the association between health behaviors and GWG, using adequate GWG as the reference. Of the 457 women included, deliveries occurred at 3.2years (mean) from visit 1; 48.7% of women had excessive GWG. Mean AHEI-2010 scores were < 45% for women of all Hispanic/Latina backgrounds. There was no association between each 10-unit increase in AHEI-2010 or a 500kcal/day increase in energy intake for mean and categorical GWG. There was no association between 30min/day higher sedentary behavior, 30min/day higher physical activity, or meeting the 2008 US physical activity guidelines for mean and categorical GWG. We did not find any association between diet quality, sedentary behavior, and physical activity at visit 1 with GWG in pregnancies occurring between visits 1 and 2. We noted widespread poor diet quality as measured by the AHEI-2010 and low levels of physical activity among Hispanic/Latina women.

Association between pregnancy intention and preconception health behaviors.

Female adolescent and young adult (AYA) cancer survivors face higher infertility and pregnancy risks than peers with no cancer history. Preconception health behaviors such as physical activity (PA), tobacco smoking, and alcohol intake influence reproductive outcomes. In general populations, pregnancy intention is positively associated with healthy preconception behaviors, but it has not been studied among AYA survivors. The authors hypothesized that higher pregnancy intention would be associated with healthier behaviors, especially among AYA survivors with perceived infertility risk. A cross-sectional analysis was conducted with data collected between 2013 and 2017 from 1071 female AYA survivors aged 18 to 39 years who had completed their primary cancer treatment and enrolled in an ovarian function study. Self-reported intention dimensions were measured as a pregnancy intention score (PIS) and trying now to become pregnant. Multivariable linear (PA), binary (smoking), and ordinal (alcohol use) logistic regressions were used to estimate associations between intentions and preconception behaviors, with adjustments made for demographic and cancer characteristics. Effect modification by perceived infertility risk was assessed. The mean PIS was 1.1 (SD, 0.77) on a 0 to 2 scale (2 = high intention), and 8.9% were attempting pregnancy now. A higher PIS was associated with increased PA (β, 0.08; 95% CI, 0.11-1.04), whereas ambivalence in pregnancy intention was associated with lower alcohol consumption (odds ratio, 0.72; 95% CI, 0.55-0.95). Pregnancy intentions were not associated with smoking. Perceived infertility risk strengthened the relationship between PIS and PA (P < .05). Pregnancy intentions were associated with some healthier preconception behaviors in AYA survivors. Medical professionals caring for AYA survivors may consider pregnancy intention screening to guide conversations on preconception health.

Utilization of preconception care and its impacts on health behavior changes among expectant couples in Shanghai, China

BackgroundPreconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for women and their offspring. Preconception care has been established in maternal and child health hospitals in Shanghai, China, which consists of health checkups, health education and counseling. This study investigated factors associated with the utilization of preconception care, and the role of preconception care on health behavior changes before conception among pregnant women and their partners.MethodsA cross-sectional study was conducted among pregnant women at three maternal and child health hospitals in Shanghai. The participants were invited to complete a self-administered questionnaire on the utilization of preconception care and health behavioral changes before conception.ResultsOf the 948 recruited pregnant women, less than half (42.2%) reported that they had utilized preconception care before the current pregnancy. Unplanned pregnancy, unawareness of preconception care and already having a general physical examination were the main reasons for not attending preconception care. The two main sources of information about preconception care were local community workers and health professionals. Younger women and the multipara were less likely to utilize preconception care. Women who utilized preconception care were more likely to take folic acid supplements before conception [Adjusted Odds Ration (aOR) 3.27, 95% Confidence Interval (CI) 2.45–4.36, P < 0.0001]. The partners of pregnant women who had attended preconception care services were more likely to stop smoking [aOR 2.76, 95%CI 1.48–5.17, P = 0.002] and to stop drinking [aOR 2.13, 95%CI 1.03–4.39, P = 0.041] before conception.ConclusionsUtilization of preconception care was demonstrated to be positively associated with preconception health behavior changes such as women taking folic acid supplements before pregnancy, their male partner stopping smoking and drinking before conception. Future studies are needed to explore barriers to utilizing preconception care services and understand the quality of the services. Strategies of promoting preconception care to expectant couples, especially to young and multipara women, should be developed to further improve the utilization of the services at the community level.

Association Between Recommended Preconception Health Behaviors and Screenings and Improvements in Cardiometabolic Outcomes of Pregnancy.

IntroductionGestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) are associated with increased risk of maternal and infant illness and long-term elevated cardiometabolic risk. Little information exists on the prevention of either disorder before pregnancy. Our goal was to describe the association between preconception indicators and risk of gestational diabetes and hypertensive disorders of pregnancy.MethodsWe used logistic regression to analyze cross-sectional data from the 2016–2017 Pregnancy Risk Assessment Monitoring System (N = 68,493) to quantify the association between 14 preconception health indicators (across domains of health care, nutrition and physical activity, tobacco and alcohol, chronic conditions, mental health, and emotional and social support) and, separately, GDM and HDP. We accounted for sampling weights and controlled for maternal age, race/ethnicity, prepregnancy insurance, prepregnancy body mass index, and report of a check-up in the year before pregnancy.ResultsPrepregnancy obesity was the strongest predictor of both HDP (adjusted odds ratio [aOR], 3.1; 95% CI, 2.8–3.5) and GDM (aOR, 3.1; 95% CI, 2.7–3.5). Individual behaviors (eg, exercise, attending a check-up) were not associated with either HDP or GDM. A diagnosis of diabetes before pregnancy predicted HDP (aOR, 2.3; 95% CI, 1.7–3.0).ConclusionPrepregnancy chronic disease and obesity predicted pregnancy complications (ie, GDM and HDP). Given the challenges in reversing these conditions in the year before pregnancy, efforts to improve preconception health may be best directed broadly to expand access to primary care for all women.

Preconception care from a public health perspective

Abstract Public health researchers and practitioners are committed to developing, implementing and supporting initiatives that improve the health of the population. This presentation will provide an overview of the alignment between public health and preconception health. It will also overview ideas, theories and models that are central to the contemporary understanding of preconception health, such as epigenetics, the diverse preconception health behaviours and exposures that impact on outcomes, and the known barriers affecting the delivery of preconception care services. The presentation will draw on the principles of health promotion, health services research and epidemiology to provide a high-level understanding of the levers underpinning effective preconception health interventions at a policy, health services and grass-roots level.