257898 Prevention and health promotion for women of childbearing age: Preconception healthcare in a Midwest rural state

Tuesday, October 30, 2012 : 11:35 AM - 11:55 AM

Cristina R. Lammers, MD, MPH , College of Nursing and Health Science Department, South Dakota State University, Brookings, SD
Taylor Mertz , College of Nursing and Health Science Department, South Dakota State University, Brookings, SD
Shivaram Poigai, MS, MPH , College of Nursing and Health Science Department, South Dakota State University, Brookings, SD
Background/Objectives: Women's preconception health affects pregnancy and children health outcomes. This study aimed to assess women's awareness of preconception healthcare, and to identify preconception services they received. Methods: Five years after the Center for Disease Control (CDC) recommendations, we conducted a cross-sectional study among women age 18 to 45 attending WIC clinics. Women completed a questionnaire adapted from Frey and Files, based on CDC recommendations. Data from 1,426 surveys were analyzed and adjusted odd ratios (OR) (95% confidence interval [CI]) were calculated to investigate associations between women's awareness of preconception healthcare and demographic and reproductive characteristics. Results: Most women saw a health provider the year before, yet 49% were either unaware or did not receive preconception healthcare, and 67% reported previous unintended pregnancies. Two-thirds were offered five or fewer preconception services known to improve perinatal outcomes. One half had their blood pressure checked; 33.7% received reproductive planning assessment; less than 18% were advised on folic acid supplementation, or hepatitis B and rubella immune status. Preconception healthcare awareness was lower among women with previous unintended pregnancies (95%CI =1.45, 12.47), no health insurance (95%CI=1.05, 1.81), who were single (95%CI=1.03, 1.60), used primarily Emergency Room care (95%CI=1.07, 2.08), and had lower educational level (95%CI=1.01, 1.61). Conclusions: A gap was identified between preconception healthcare recommendations and actual services received. Modifiable variables associated with lower awareness and lack of preconception services were identified, representing a good starting point to develop interventions and policies to make preconception healthcare a reality for childbearing age women.

Learning Areas:
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
- Identify key components of preconception healthcare as recommended by the CDC, based on best evidence available. - Demonstrate a gap between recommended preconception healthcare and actual services provided to women of childbearing age. - Explain the need to increase women's awareness and access to preconception healthcare, especially among those at highest risk.

Keywords: Women's Quality Care, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal and co-investigator in several research studies in Latin American and Caribbean countries, as a professional with the Pan American Health Organization, Latin American Center for Perinatology and Human Development. In addition to research, I have worked as a full time professional consultant on Maternal, Child and Adolescent Health through the same organization from 1998-2001, and currently continue to collaborate with them.
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.