Preconception health of women with and without chronic health conditions

Background: Women with chronic conditions are at an increased risk of complications, should they become pregnant. We hypothesized that preconception health status differed depending upon the presence or absence of a chronic condition (i.e., diabetes, hypertension, and obesity).

Methods: Secondary analysis of cross-sectional data from the BRFSS (2002-2008). Subjects were a sample of non-institutionalized, 18-44 year old, non-pregnant, fertile women (n = 422, 649). Women were grouped into two categories: Chronic condition (n = 118,857) and no chronic condition (n = 303,792). Logistic regression was used to calculate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI) for lifestyle and screening behaviors, using women without chronic conditions as the referent group.

Results: Women with chronic conditions represented 28% of the population and were 8% less likely to drink any alcohol (aPOR=0.91, CI: 0.85,0.98), 15% less likely to exercise (aPOR=0.85, CI: 0.79,0.92); and 33% less likely to have visited a dentist (aPOR=0.77, CI: 0.68, 0.88) than women without a chronic condition, after adjusting for demographic differences. Women with chronic conditions that were intending a pregnancy reported a lower prevalence of any alcohol use (48.8% vs. 58.9%), leisure activity (73.5% vs. 80.5%), folic acid consumption (46.1% vs. 61.3%), and dental visits (64.9% vs. 75.9%), and higher prevalence of having had an HIV test (66.4% vs. 61.5%), than women without a chronic condition that were intending a pregnancy, respectively.

Conclusions: Women with chronic conditions, especially those intending a pregnancy, represent an important group for preconception care and education.