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BMC Pregnancy and Childbirth Jul 2021Preconception care is an opportunity for detecting potential health risks in future parents and providing health behavior education to reduce morbidity and mortality for...
BACKGROUND
Preconception 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.
METHODS
A 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.
RESULTS
Of 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.
CONCLUSIONS
Utilization 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.
Topics: Adult; China; Cross-Sectional Studies; Dietary Supplements; Family Characteristics; Female; Folic Acid; Health Behavior; Humans; Male; Patient Acceptance of Health Care; Preconception Care; Pregnancy; Pregnant Women; Surveys and Questionnaires
PubMed: 34233653
DOI: 10.1186/s12884-021-03940-0 -
Annals of Internal Medicine May 2022
Topics: Diabetes Mellitus; Fathers; Female; Humans; Male; Preconception Care; Pregnancy
PubMed: 35344373
DOI: 10.7326/M22-0770 -
BMJ (Clinical Research Ed.) Jan 2022
Topics: Fertilization; Folic Acid Deficiency; General Practitioners; Humans; Malpractice; Neural Tube Defects; Preconception Care; United Kingdom
PubMed: 35031556
DOI: 10.1136/bmj.o79 -
Reproductive Health Nov 2021Preconception care is one of the preventive strategies in maternal and new-born health as recommended by WHO. However, in sub-Saharan Africa there is poor preconception...
BACKGROUND
Preconception care is one of the preventive strategies in maternal and new-born health as recommended by WHO. However, in sub-Saharan Africa there is poor preconception care practices. This study examined knowledge and perceptions of preconception care among health workers and women of reproductive age group in Mzuzu City, Malawi.
METHODS
A descriptive cross-sectional study was conducted using a mixed methods approach. Selection of respondents was done through a multistage and purposive sampling techniques respectively. A total of 253 women of reproductive age from nine townships of Mzuzu City responded to the questionnaire and 20 health workers were interviewed.
RESULTS
A total of 136 (54%) respondents had heard of preconception care. About 57.7% (n = 146) demonstrated a good level of knowledge of preconception care while 42.3% (n = 107) had poor knowledge. About 72% (n = 105) of those with good of knowledge of preconception care, lacked awareness on possibilities of talking to a health care provider on intentions of getting pregnant. About 74.7% (n = 189) of women had a positive perception towards preconception care. Knowledge of preconception care was a good predictor of positive perception (AOR = 2.5; 95% CI 1.2-5.0), however its predictability was influenced by the academic level attained. Those with secondary (AOR = 10.2; 95% CI 3.2-26.2) and tertiary (AOR = 2.3; 95% CI 1.1-4.9) were more likely to have good knowledge of preconception care than those with primary school education level. About 95% (n = 19) of health workers lacked details about preconception care but they admitted their role in preconception care.
CONCLUSION
Preconception care practice among health workers and women of reproductive age in Mzuzu City was low. However there was positive perception towards preconception care in both parties. There is an opportunity in existing platforms for implementation of interventions targeting identified predictors for increased knowledge and uptake of preconception care.
Topics: Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Health Personnel; Humans; Malawi; Perception; Preconception Care; Pregnancy
PubMed: 34775983
DOI: 10.1186/s12978-021-01282-w -
Best Practice & Research. Clinical... Apr 2020Appropriate contraception and preconception counseling are critical for women of reproductive age with systemic autoimmune diseases (AIDs) because clinical diagnosis,... (Review)
Review
Appropriate contraception and preconception counseling are critical for women of reproductive age with systemic autoimmune diseases (AIDs) because clinical diagnosis, rheumatology medications, and disease activity may impact the safety or efficacy of certain contraceptives as well as the risk of adverse pregnancy outcomes. The presence of antiphospholipid (aPL) antibodies (anticardiolipin, anti-β2 glycoprotein I, and lupus anticoagulant) is the most important determinant of contraception choice, as women with these antibodies should not receive estrogen-containing contraceptives because of the increased risk of thrombosis. Prepregnancy counseling generally includes the assessment of preexisting disease-related organ damage, current disease activity, aPL antibodies, anti-Ro/SS-A and anti-La/SS-B antibodies, and medication safety in pregnancy. Quiescent AID for six months on pregnancy-compatible medications optimizes maternal and fetal/neonatal outcomes for most patients.
Topics: Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Autoimmune Diseases; Contraception; Counseling; Female; Humans; Preconception Care; Pregnancy; Pregnancy Outcome; Risk Factors
PubMed: 31679995
DOI: 10.1016/j.bpobgyn.2019.09.003 -
Journal of Women's Health (2002) Mar 2023Preconception diabetes is strongly associated with adverse birth outcomes. Less is known about the effects of elevated glycemia at levels below clinical cutoffs for...
Preconception diabetes is strongly associated with adverse birth outcomes. Less is known about the effects of elevated glycemia at levels below clinical cutoffs for diabetes. In this study, we estimated associations between preconception diabetes, prediabetes, and hemoglobin A1c (HbA1c) on the risk of preterm birth, and evaluated whether associations were modified by access to or utilization of health care services. We used data from Add Health, a US prospective cohort study with five study waves to date. At Wave IV (ages 24-32), glucose and HbA1c were measured. At Wave V (ages 32-42), women with a live birth reported whether the baby was born preterm. The analytic sample size was 1989. The prevalence of preterm birth was 13%. Before pregnancy, 6.9% of women had diabetes, 23.7% had prediabetes, and 69.4% were normoglycemic. Compared to the normoglycemic group, women with diabetes had 2.1 (confidence interval [95% CI]: 1.5-2.9) times the risk of preterm birth, while women with prediabetes had 1.3 (95% CI: 1.0, 1.7) times the risk of preterm birth. There was a nonlinear relationship between HbA1c and preterm birth such that risk of preterm birth emerged after HbA1c = 5.7%, a standard cutoff for prediabetes. The excess risks of preterm birth associated with elevated HbA1c were four to five times larger among women who reported unstable health care coverage and among women who used the emergency room as usual source of care. Our findings replicate prior research showing strong associations between preconception diabetes and preterm birth, adding that prediabetes is also associated with higher risk. Policies and interventions to enhance access and utilization of health care among women before pregnancy should be examined.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Young Adult; Adult; Premature Birth; Glycated Hemoglobin; Prospective Studies; Prediabetic State; Health Services Accessibility; Preconception Care
PubMed: 36796052
DOI: 10.1089/jwh.2022.0256 -
BMC Pregnancy and Childbirth Sep 2023Despite 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...
BACKGROUND
Despite 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.
METHODS
A 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.
RESULTS
The 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.
CONCLUSIONS
This 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.
Topics: Female; Child; Pregnancy; Humans; Pregnant Women; Preconception Care; Ethiopia; Cross-Sectional Studies; Hospitals, Private; Mothers; Pregnancy, Unplanned
PubMed: 37684575
DOI: 10.1186/s12884-023-05955-1 -
BMC Pregnancy and Childbirth Nov 2021Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and...
BACKGROUND
Preconception care (PCC) is a form of preventive health care that is offered to women and couples before conception, with the aim of improving their health status and mitigating various risk factors that could contribute to poor maternal and child health outcomes. The levels of PCC utilization are still low globally, especially in developing countries and in rural areas. Little is known regarding PCC use in Kenya that could help in addressing this shortfall. This study aimed to qualitatively assess the determinants of PCC in urban and rural settings in Kenya.
METHODS
A qualitative approach was employed to assess determinants of PCC using a semi-structured interview guide. The study was conducted from May to October 2017. Selected pregnant women seeking antenatal care (ANC) were recruited by quota sampling, 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 interviews were thereafter transcribed verbatim and analyzed thematically.
FINDINGS
A total of 26 women were invited, of whom 21 accepted to participate in in-depth interviews (IDIs). Saturation of themes occurred with 13 interviews (7 at AKUH and 6 at MLFH). Transcription, coding and thematic analysis of the IDIs yielded 12 themes. Eleven of these themes were identified as determinants of PCC. The twelfth theme contained suggested strategies of increasing PCC awareness and utilization, such as using the media, setting up PCC clinics and integrating PCC into other clinics. The dominant themes were awareness about PCC and attitudes towards PCC and pregnancy. The broad determinants of PCC were similar in urban and rural settings - with a few notable exceptions. For example, in the rural setting, women's level of education and a pervasive history of poor interactions with healthcare providers were major determinants of PCC.
CONCLUSION
From this study we conclude that women's lack of awareness about PCC, in conjunction with attitudes towards PCC and pregnancy impact strongly on its utilization. This lack of awareness could be addressed through health education programs for both the public and for healthcare providers, as well as integrating PCC in the curricula of the later.
Topics: Adult; Attitude to Health; Female; Humans; Kenya; Patient Acceptance of Health Care; Preconception Care; Pregnancy; Pregnant Women; Qualitative Research; Rural Population; Urban Population
PubMed: 34743694
DOI: 10.1186/s12884-021-04201-w -
JAMA Dec 2021
Topics: Female; Humans; Preconception Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome
PubMed: 34874428
DOI: 10.1001/jama.2021.16759 -
JAMA Dec 2021
Topics: Female; Humans; Preconception Care; Pregnancy; Pregnancy Complications; Pregnancy Outcome
PubMed: 34874423
DOI: 10.1001/jama.2021.16762