171440 Impact of preconception counseling on maternal behaviors before and during pregnancy

Tuesday, October 28, 2008: 12:35 PM

Lauren Zapata, PhD, MSPH , Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA
Letitia Williams, MPH , Division of Reproductive Health, CDC, Atlanta, GA
Brian Morrow, MA , Division of Reproductive Health, CDC, Atlanta, GA
Denise D'Angelo, MPH , Division of Reproductive Health, CDC, Atlanta, GA
Leslie Harrison, MPH , Division of Reproductive Health, CDC, Atlanta, GA
Preconception counseling is a vital component of preconception care. Through counseling, providers educate and recommend strategies to improve health and birth outcomes for reproductive age women. Although evidence supports the effectiveness of specific interventions that might be part of preconception counseling (e.g., folic acid supplementation, smoking cessation, obesity control), few studies have examined the effectiveness of preconception counseling in general. The purpose of this analysis was to assess the associations between receipt of preconception counseling and positive maternal behaviors before and during pregnancy (i.e., pre-pregnancy daily multivitamin consumption, first trimester prenatal care, and smoking and drinking cessation during pregnancy among women who smoke/drank during the 3 months before pregnancy). We analyzed 2004-2005 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from five states (Louisiana, Maine, New Jersey, Utah, and Vermont). Multivariable logistic regression was used to investigate the associations between receipt of preconception counseling and each of our outcomes, adjusting for a wide range of maternal characteristics. Overall, 31% of women reported receipt of preconception counseling (43% among women with an intended pregnancy and 13% among those with an unintended pregnancy). Receipt of counseling, after adjustment, was associated with daily pre-pregnancy multivitamin consumption (AOR=4.6, 95% CIs=4.0, 5.1), first trimester entry into prenatal care (AOR=1.8, 95% CIs =1.5, 2.1), and smoking cessation during pregnancy (AOR=1.5, 95% CIs=1.1, 1.9). Findings indicate that preconception counseling is a successful tool in the promotion of positive maternal behaviors that increase the likelihood of a healthy pregnancy, woman, and infant.

Learning Objectives:
1. Articulate the importance of preconception counseling in the promotion of women’s and children's health. 2. Discuss the impact of counseling on multivitamin consumption, early entry into prenatal care, and alcohol and tobacco cessation during pregnancy. 3. Identify subgroups of women less likely to receive preconception counseling.

Keywords: Women's Health, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was heavily involved in the conceptualization of the research questions, methodology, and interpretation of findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Women's Health
See more of: Epidemiology