Los Angeles Mommy and Baby (LAMB) Project: Preconception health conditions related to preterm infants

Objective: Appropriate preconception health care can improve birth outcomes. We examined preconception health status and adverse birth outcomes - low birth weight (LBW) and preterm (PT) births- in LAC.

Methods: The LAMB Project surveyed a representative sample of postpartum women to identify risk factors for adverse birth outcomes. Questions related to preconception health included: maternal medical conditions, psychosocial factors, insurance status, and risk taking behaviors prior to pregnancy. The adjusted odds ratio (OR) generated from logistic regression models were used to identify factors associated with LBW and PT births. The models were adjusted for age, race, education level, and marital status.

Results: The data presented are from the first half of the project. Among the 2,409 respondents, 202 mothers experienced LBW birth and 348 moms experienced PT birth. Preliminary findings show that previous LBW/PT and pre-pregnancy high blood pressure (HBP) were associated with LBW birth (ORLBW/PT=2.7, CI=1.8, 4.0; ORHBP=2.7, CI=1.5, 4.6) and PT birth (ORLBW/PT=2.8, CI=2.0, 3.9; ORHBP=2.6, CI=1.6, 4.3). Overweight prior to pregnancy was associated with LBW birth (OR=1.5, CI=1.1, 2.0); lack of medical insurance prior to pregnancy was associated with PT birth (OR=1.3, CI=1.0, 1.7). Unintended pregnancy and intimate partner abuse were not associated with either adverse outcome.

Conclusion: Our findings confirm that preconception care improves birth outcomes, whether or not pregnancy is intended. Preconception care should include the identification, treatment, and modification of factors linked to adverse birth outcomes. Increasing resources for such care is an opportunity to promote the health of women, children, and families.