Impact of preconception counseling on maternal behaviors before and during pregnancy

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.