Utilization Of Preconception Care Research Articles

Preconception care utilization: Self-report versus claims-based measures among women with Medicaid.

The objective of this study is to compare self-reported preconception care utilization (PCU) among Medicaid-covered births to Medicaid claims. We identified all Medicaid-covered births to women ages 15-45 in 26 states in the year 2012 among the Pregnancy Risk Assessment and Monitoring System (PRAMS) survey and Medicaid Analytic eXtract (MAX) claims data, and identified preconception services in the latter using diagnosis codes published by Health and Human Services' Office of Population Affairs. We fit mixed-effects logistic regression models for the probability of PCU on sociodemographic factors (age, race, and ethnicity) and clinical diagnoses (depression, diabetes, or hypertension), separately for each dataset. Among 652,929 women delivering in MAX, 28.1% received at least one claims-based preconception service while an estimated 23.6% (95% CI 22.1-25.3) of PRAMS respondents reported receiving preconception care. Adjusting for age, chronic diseases, and state, PCU rates in both MAX and PRAMS were higher for non-Hispanic Black versus non-Hispanic White women (OR 1.51, 95% CI 1.49-1.54 and OR 2.05, 95% CI 1.60-2.62, respectively). Adjusting for differences in age, race and ethnicity, and state, PCU rates were higher for patients with diabetes (OR 1.34, 95% CI 1.29-1.40 and OR 1.82, 95% CI 1.16-2.85) or hypertension (OR 1.22, 95% CI 1.18-1.27 and OR 1.85, 95% CI 1.41-2.44). While Hispanic and Asian women were also more likely to report PCU than their non-Hispanic White counterparts (OR 2.07, 95% CI 1.53-2.80 and OR 3.37, 95% CI 2.28-4.98), they were less likely to have received it (OR 0.74, 95% CI 0.73-0.75 and OR 0.65, 95% CI 0.63-0.67). In conclusion, comparing self-report to claims measures of PCU, we found similar trends in the differences between non-Hispanic Black and White women, and between those with vs. without diabetes and hypertension. However, the two data sources differed in trends in other racial/ethnic groups (differences between Hispanic vs. non-Hispanic White women, and between Asian vs. non-Hispanic White women), and in those with vs. without depression. This suggests that while Medicaid claims can be a useful tool for studying preconception care, they may miss certain types of care among some sub-groups of the population or be subject to reporting differences that are hard to surmise. Both data sets have potential benefits and drawbacks as research tools.

Utilization of preconception care and associated factors among pregnant mothers in Fiche Town, Central Ethiopia: a community-based cross-sectional study 2021.

Preconception care is an important preventive intervention for adverse pregnancy outcomes. It is recognized as a strategy to optimize women's health and pregnancy outcomes in Western countries. However, preconception care is underutilized in sub-Saharan Africa, like Ethiopia, where maternal mortality is high. Evidence is scarce in the study area about the prevalence and factors associated with preconception care utilization. Therefore this study aimed to assess the proportion of preconception care utilization and associated factors among pregnant mothers in Fiche town, central Ethiopia, 2021. A community-based cross-sectional study was done from May 10 to June 25, 2021. A systematic random sample technique was used to choose 393 pregnant women for the study. A structured, pre-tested, interviewer-administered questionnaire was used to collect data. The data were entered into Epi Data version 3.1 and then exported into SPSS version 25 for analysis. A Bivariable and multivariable logistic regression analysis was used to check for the association. Odds ratio along with 95% was used to describe the association. Finally, a significant association was declared at a p-value less than 0.05. 388 respondents participated in this study, making the response rate 98.7%. Of total study participants only 84 (21.6%; 95% CI, 18, 25.8) utilized preconception care. The study found that diploma or higher level of education (AOR = 3.47, 95% CI: 1.27, 9.53), psychological and financial support from a partner (AOR = 3.86, 95% CI: 2.1, 7.10), joint discussion and plan with a partner (AOR = 3.32, 95% CI: 1.55, 7.13), history of chronic disease (AOR = 3.47, 95% CI: 1.67, 7.25), and good knowledge about preconception care (AOR = 2.42, 95% CI: 1.34, 4.38) were significantly associated with preconception care utilization. Overall, less than a quarter of the pregnant mothers utilized preconception care, indicating that awareness is very low. Pregnant mothers who have a higher educational level, have good communication and support from their partners, have chronic health problems, and have good knowledge about preconception care were more likely to utilize the service. Preconception care is a better opportunity to intervene and maintain the mother in the continuum of care.

Utilization of preconception care and associated factors among pregnant women attending ANC in private MCH Hospitals in Addis Ababa, Ethiopia

BackgroundDespite its benefit in promoting maternal health and the health of her developing fetus, little is known about preconception care practice and its associated factors in Ethiopia. Moreover, preconception care utilization in private hospitals is not known. The purpose of this study, therefore, is to determine the utilization of preconception health care services and its associated factors among pregnant women following antenatal care in the private Maternal and Child Health hospitals in Addis Ababa.MethodsA Hospital based cross-sectional study was conducted from April 1 to April 30,2022 among 385 women attending ANC in private MCH hospitals. Bestegah and Hemen MCH hospitals were selected by convenience method. Data were collected by a pretested self-administered semi-structured questionnaire. To identify the factors associated with the utilization of preconception care, bivariable and multivariable logistic regression analysis were performed. Adjusted odds ratios with 95% confidence interval were estimated to assess the strength of associations, and statistical significance was declared at a p-value < 0.05.ResultsThe utilization of preconception care among the pregnant mothers according to our study was 40%. Professional/technical/managerial occupation (AOR = 4.3, 95%CI = 1.13, 16.33, P < 0.032), having good knowledge on preconception care (AOR = 3.5, 95%CI = 1.92, 6.53, P < 0.000), having unintended pregnancy (AOR = 0.1, 95%CI = 0.03, 0.42, P < 0.001), history of family planning use before conception (AOR = 3.9, 95%CI = 1.20, 12.60, P < 0.023), having pre-existing medical disease(s) (AOR = 8.4, 95%CI = 2.83, 24.74, P < 0.002), and having adverse pregnancy outcome(s) in previous pregnancies (AOR = 3.2, 95%CI = 1.55, 6.50, P < 0.000) were significantly associated with preconception care utilization.ConclusionsThis study found out that the utilization of preconception care in the private MCH hospitals is still low i.e., only 40%. Occupation, level of knowledge, having unintended pregnancy, history of family planning use before conception, having adverse pregnancy outcome(s) in previous pregnancy and having pre-existing medical disease(s) were independently associated with preconception care utilization. Lack of awareness about the availability of the services and having an unintended pregnancy were the main reasons for not utilizing preconception care.

Preconception Care Utilization and Its Associated Factors Among Women in Debre Tabor Town Northwest Ethiopia: Community Based Cross-Sectional Study

Although preconception care is a key element of motherhood health care services, the package is ignored in developing countries including Ethiopia and has not been generally adopted and applied since its aim and purposes are not broadly unstated and incorporated. Therefore, the objective of the current study was to determine the level of preconception care use and its determinants among women in Debre Tabor Town Northwest Ethiopia. From November 1 to 30, 2020, a Community-based cross-sectional study was undertaken in Debre Tabor Town. Overall, 79 (15.8%) with 95% CI [12.6, 19] of women had a good level of practice on preconception care utilization. Age (35–49; AOR = 5.12, 95% CI [2.14, 9.98]), ante natal care (AOR = 8.78, 95% CI [2.66, 28.97]), history of adverse birth outcome (AOR = 4.89, 95% CI [3.09, 17.00]), presence of chronic disease (AOR = 7.51, 95% CI [2.33, 12.13]), and knowledge on preconception care (AOR = 3.55, 95% CI [1.57, 8.02]) were significantly associated with utilization of preconception care. Hence, the government and respective stakeholders must give establish on preconception care strategies and plan that covers all aspects of preconception care. Incorporation of the service with other maternal and child health service will be crucial when developing actual employment policies to scale up acceptance of preconception care.

Assessing the Level of Awareness and Utilization of Preconception Care among Saudi Women in Al Ahsa, Saudi Arabia

About 810 women died every day in 2017 from preventable causes related to pregnancy and childbirth. To reduce the risks of maternal and fetal complications during pregnancy, knowledge about preconception care must be increased. Preconception care is closely linked to maternal and infant health. This study aimed to examine the level of knowledge, attitudes, and utilization of preconception care among women in Al Ahsa, Saudi Arabia. A cross- sectional study was conducted between June 27 and September 30, 2021, in three governmental hospitals and three private hospitals from the outpatient department of Al Ahsa, Saudi Arabia. In this study, the participants were recruited using a simple randomization technique. The estimated sample size is 386. Data were collected by using a modified structured questionnaire adapted from similar studies. The questionnaire contains three sections. The validity and reliability of the tool were accomplished. This study was approved by the Institutional Review Board (IRB) of the KFHH, and a letter of informed participation, along with the purposes of the study, was provided with the administered questionnaire. Near to half of the study participants, 166 (43%) had good knowledge, and 186 (48.2%) had fair knowledge on preconception care whereas 34 (8.8%) had poor knowledge on preconception care. Regarding the utilization, most participants 170 (44%) did not receive complete preconception care. The majority of participants (73.6%) said that women don't undertake complete preconception care due to a lack of knowledge. The level of education of participants is strongly correlated with preconception care awareness. The findings concluded that fewer than half of Saudi women in Al Ahsa were aware about preconception care. In general, responders do not use preconception care services due to a lack of knowledge about how these services may affect maternal and neonatal health.

Preconception Care Utilization among Childbearing Women in South-East Nigeria

Adverse pregnancy outcomes remain a challenging health problem in Nigeria. Before conception, couples need to utilize preconception care which is meant to address most of the reproductive health risks. However, the use of this service and its determinants is not well investigated globally. This Cross-sectional study was aimed at assessing the utilization of preconception care and its determinants among mothers in South-East Nigeria. Pre-tested and validated structured Questionnaire on Preconception Care Utilization was used to collect data from 350 postnatal women who were systematically selected from 33 sampled health facilities. Data were collated and entered into SPSS version 20. Binary logistic regression was used to determine the association between the demographic characteristics of the mothers and the utilization of preconception care. Statistical significance was set at p&lt;0.05. Results show that only 23.4% of the mothers utilized preconception care. Parity, employment status, and pregnancy intention were significantly associated with preconception care utilization. The odd of utilizing preconception care were 60.2% lower among multiparous women than primiparous women. Working-class mothers were more than 70% less likely to utilize preconception care than mothers who were not employed. Mothers whose pregnancy was intended were 3.4 times more likely to utilized preconception care than mothers whose pregnancy was unintended. Health facilities should establish functional clinics with the availability of evidence-based guidelines to improve uptake of preconception care. Health care professionals should intensify their efforts in encouraging women to receive preconception care.

Mothers' utilization and associated factors of preconception care in Africa, a systematic review and meta-analysis.

As the studies show, in every minute in the world, 380 women become pregnant and 190 face unplanned or unwanted pregnancies; 110 experience pregnancy-related complications, and one woman dies from a pregnancy-related cause. Preconception care is one of the proven strategies for the reduction in mortality and decreases the risk of adverse health effects for the woman, fetus, and neonate by optimizing maternal health services and improves woman's health. Therefore, this study aimed to estimate the pooled prevalence of utilization of preconception of care and associated factors in Africa. Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL, and manually on Google Scholar. This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of studies was assessed by the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using a random-effects method using the STATA™ Version 14 software. From 249,301 obtained studies, 28 studies from 3 African regions involving 13067 women included in this Meta-analysis. The overall pooled prevalence of utilization of preconception care among pregnant women in Africa was found to be 18.72% (95% CI: 14.44, 23.00). Knowledge of preconception care (P = <0.001), preexisting medical condition (P = 0.045), and pregnancy intention (P = 0.016) were significantly associated with the utilization of preconception care. The results of this meta-analysis indicated, as one of best approaches to improve birth outcomes, the utilization of preconception care is significantly low among mothers in Africa. Therefore, health care organizations should work on strategies to improve preconception care utilization.

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.

Preconception Care among Pregnant Women in an Urban and a Rural Health Facility in Kenya: A Quantitative Study.

Preconception care (PCC) aims to improve maternal and fetal health outcomes, however, its utilization remains low in developing countries. This pilot study assesses the level and determinants of PCC in an urban and a rural health facility in Kenya. Unselected pregnant women were recruited consecutively at the Mother and Child Health (MCH) clinics in Aga Khan University Hospital, Nairobi (AKUH, N-urban) and Maragua Level Four Hospital (MLFH-rural). The utilization of PCC was defined as contact with any health care provider before current pregnancy and addressing pregnancy planning and preparation. A cross-sectional approach was employed and data were analyzed using SPSS version 22. 194 participants were recruited (97 in each setting) of whom, 25.8% received PCC. Age, marital status, education, parity and occupation were significant determinants of PCC uptake. There was also a significant difference in PCC uptake between the rural (16.5%) and urban (35.1%) participants (p < 0.01), OR of 0.3 (0.19–0.72, 95% CI). The low level of PCC in Kenya revealed in this study is consistent with the low levels globally. However, this study was not powered to allow firm conclusions and analyze the true effects of PCC determinants. Therefore, further research in the field is recommended in order to inform strategies for increasing PCC utilization and awareness in Kenya.

Knowledge and utilization of preconception care among women in selected community of Kathmandu

Introduction: Preconception care is a critical component of maternal and child health care services to reduce adverse outcomes of pregnancy and to improve desired health outcomes for women, new-born, and children by focusing on health promotion, screening, and interventions. This study aimed to find out the knowledge and utilization of preconception care among women.&#x0D; Method: A cross-sectional design was carried out among women. Non-probability purposive sampling technique was adopted to select married women of reproductive age in Tokha municipality-10, Kathmandu. Data was collected using face-to-face structured interview. Descriptive and inferential statistics were used to analyze the data. Association among variables was measured by Kruskal–Wallis H test.&#x0D; Result: More than half of the 200 women surveyed, 133 (66.5%) had average level of knowledge and 61 (30.5%) adequate and 6 (3%) inadequate level of knowledge regarding preconception care. Similarly, 196 (98%) had low utilization and 4 (2%) had high utilization level. There was statistically significant association between educational level of respondents with the level of knowledge (p=0.05) and their husband’s educational level (p=0.00). There was no significant association with age, type of family, occupation, monthly family income, number of pregnancy, history of abortion/still birth and age at first pregnancy.&#x0D; Conclusion: This study shows more than half of respondents had an average level of knowledge about preconception care whereas only 2% had high level of utilization of care.

The effect of a preconception care outreach strategy: the Healthy Pregnancy 4 All study

BackgroundPreconception care has been acknowledged as an intervention to reduce perinatal mortality and morbidity. However, utilization of preconception care is low because of low awareness of availability and benefits of the service. An outreach strategy was employed to promote uptake of preconception care consultations. Its effect on the uptake of preconception care consultations was evaluated within the Healthy Pregnancy 4 All study.MethodsWe conducted a community-based intervention study. The outreach strategy for preconception care consultations included four approaches: (1) letters from municipal health services; (2) letters from general practitioners; (3) information leaflets by preventive child healthcare services and (4) encouragement by peer health educators. The target population was set as women aged 18 to 41 years in 14 Dutch municipalities with relatively high perinatal morbidity and mortality rates. We evaluated the effect of the outreach strategy by analyzing uptake of preconception care consultations between February 2013 and December 2014. Registration data of applications for preconception care as well as participant questionnaires were obtained for analysis.ResultsThe outreach strategy led to 587 applications for preconception care consultations. The majority of applications (n = 424; 72%) were prompted by the invitation letters (132,129) from the municipalities and general practitioners. The effect of the municipal letter seemed to fade out after 3 months.ConclusionsOutreach strategies amongst the general population promote uptake of preconception care consultations, although on a small scale and with a temporary effect.

Preconception Care Utilization and its Associated Factors among Pregnant Women in Adet, North-Western Ethiopia (Implication of Reproductive Health)

Preconception Care Utilization and its Associated Factors among Pregnant Women in Adet, North-Western Ethiopia (Implication of Reproductive Health)

Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys

Objectives This study aimed to understand the impact of a previous adverse infant outcome (AIO) on use of preconception care prior to a subsequent pregnancy. Methods Responses from the 2010 and 2012 Los Angeles Mommy and Baby Surveys were analyzed. Weighted multivariate logistic regression was employed to identify significant associations between having had a previous AIO (preterm delivery, low birth weight infant, stillbirth, or major birth defect) and receipt of preconception care prior to the most recent pregnancy. Select patient-level covariates were included: chronic disease, age, education level, race/ethnicity, country of birth, insurance status prior to pregnancy and pregnancy intent. Adjustment for missing responses was performed using multiple chained imputation. Results After controlling for covariates, having had a previous AIO was associated with an increased odds of having utilized preconception care in the most recent pregnancy (OR 1.237, p=0.040). Per the final regression model, a woman reporting a previous AIO and an intended subsequent pregnancy had a 42.4% likelihood of having used preconception care. Of these women, only 28.8% reported doing so because of concern regarding a previous birth complication. Discussion Women reporting a previous AIO were more likely to have used preconception care in a subsequent pregnancy. The prevalence of preconception care utilization remained low overall. Pregnancy intent emerged as a strong secondary predictor; any concerted strategy to improve access to preconception care must include initiatives to help ensure that pregnancies are planned.