261906 Preconception counseling in California: Women aged 18-44, 2009-2010

Wednesday, October 31, 2012

Moreen Libet, PhD, MEd , Maternal, Child and Adolescent Health Division, California Home Visiting Program, California Department of Public Health, Sacramento, CA
Flojaune Griffin, PhD, MPH , Institute for Health and Aging, University of California, San Francisco, Sacramento, CA
Connie Mitchell, MD, MPH , California Department of Public Health, Maternal Child and Adolescent Health Division, Sacramento, CA
Jennifer L. Troyan, MPH , Maternal, Child and Adolescent Health Division, California Department of Public Health, Sacramento, CA
  
Background: Preconception care has been shown to improve maternal and infant health. Providing such care at routine visits is important in California because 45% of live births result from unintended pregnancies.

Methods: Data from the 2009 and 2010 California Women's Health Survey were combined to determine whether health care providers of non-pregnant women aged 18-44 with a routine visit in the past two years had discussed the following preconception health topics during the visit: pregnancy plans, smoking, diet or exercise, dental care, and folic acid use.

Results: Of 2,807 women who met inclusion criteria, less than half (41.6%) were asked whether they wanted to become pregnant in the future. Significantly more Hispanic women (49.6%, 95% CI 46.3-53.0) reported this than did white (37.4%, 95% CI 34.2-40.6), Asian/other (37.5%, 95% CI 30.7-44.2) or African-American (36.1%, 95% CI 26.2-46.0) women. Significantly more women aged 25-34 reported that the provider discussed future pregnancy (51.3%) than did 18-24- (31.8%) or 35-44-year-olds (38.9%).

Women reporting that their provider discussed future pregnancy plans were significantly more likely than those reporting no such discussion to also report that their provider addressed two or more of the behavioral preconception topics (54.3%, 95% CI 51.0-57.7 vs. 38.6%, 95% CI 35.6-41.6).

Women reported that providers were most likely to discuss diet or exercise (59.6%), and least likely to discuss taking folic acid (17.2%); 41.1% discussed smoking, and 28.8% discussed dental care.

Conclusions: The routine healthcare visit is an important opportunity for reproductive life planning and other preconception counseling.

Learning Areas:
Clinical medicine applied in public health
Provision of health care to the public
Public health or related education

Learning Objectives:
1. Describe the frequency with which particular preconception health topics were discussed during routine healthcare visits of reproductive-age women in California. 2. Differentiate patterns of preconception counseling by race/ethnicity and age. 3. Describe the association between provider discussion of future pregnancy plans and other preconception behavioral counseling for this population.

Keywords: Primary Prevention, Providers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as epidemiologist in the Preconception Health program of the California Department of Public Health Maternal, Child and Adolescent Health Division for five years. This work included major contributions to "Preconception Health: Selected Measures, California, 2005," related presentations at national meetings, participation in the development of Healthy People 2020 preconception health indicators, as well as in the multi-state work-group that developed the Core State Preconception Health Indicators for Monitoring Preconception Health.
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.

Back to: 5021.0: Improving Pregnancy Outcomes: Improving Maternal and Infant Care Over the Lifespan