Associations Between Preconception Counseling and Maternal Behaviors Before and During Pregnancy
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Preconception counseling (PCC) is a vital component of preconception care. Through counseling, providers educate and recommend strategies to improve health and birth outcomes for women of reproductive age. The objective of our analysis was to assess the associations between receipt of PCC and positive maternal behaviors before and during pregnancy. We analyzed 2004–2008 Pregnancy Risk Assessment Monitoring System data from Maine, New Jersey, Utah, and Vermont. Multivariable logistic regression was used to investigate the associations between receipt of PCC and prepregnancy daily multivitamin consumption, first-trimester entry into prenatal care, and cessation of smoking and drinking before pregnancy among women who smoked/drank in the 2 years preceding the survey, adjusting for a wide range of maternal characteristics. Overall, 32% of women reported receipt of PCC, with particularly low rates reported among women with an unintended pregnancy (14%) and no health insurance prior to pregnancy (14%). Receipt of PCC was associated with daily prepregnancy multivitamin consumption (adjusted odds ratio [AOR] = 4.4; 95% confidence interval [CI] = 4.0, 4.7), first-trimester entry into prenatal care for women with an intended pregnancy (AOR = 2.1; 95% CI = 1.8, 2.4), and drinking cessation before pregnancy among women who drank in the 2 years preceding the survey (AOR = 1.3; 95% CI = 1.2, 1.5). PCC was associated with positive maternal behaviors that increase the likelihood of a healthy woman, pregnancy, and infant. Unfortunately, less than one-third of women with a recent live birth reported receiving PCC. These data provide population-based evidence suggesting the value of PCC in the promotion of healthy maternal behaviors for women with intended or unintended pregnancies.
KeywordsPreconception care Smoking cessation Dietary supplements/utilization Drinking behavior Prenatal care
The authors thank the members of the PRAMS Working Group: Albert Woolbright, PhD (Alabama); Kathy Perham-Hester, MS, MPH (Alaska); Mary McGehee, PhD (Arkansas); Alyson Shupe, PhD; (Colorado); George Yocher, MS (Delaware); Marie Bailey, MA, MSW, MPH (Florida) Carol Hoban, MS, MPH (Georgia); Mark Eshima, MA (Hawaii); Theresa Sandidge, MA (Illinois); Joan Wightkin (Louisiana); Tom Patenaude (Maine); Diana Cheng, MD (Maryland); Hafsatou Diop, MD, MPH (Massachusetts); Violanda Grigorescu, MD, MSPH (Michigan); Judy Punyko, PhD, MPH (Minnesota); Marilyn Jones, MEd (Mississippi); Venkata Garikapaty, MSc, MS, PhD, MPH (Missouri);—JoAnn Dotson (Montana); Brenda Coufal (Nebraska); Lakota Kruse, MD (New Jersey); Eirian Coronado (New Mexico); Anne Radigan-Garcia (New York State); Candace Mulready-Ward, MPH (New York City); Paul Buescher, PhD (North Carolina); Sandra Anseth (North Dakota); Connie Geidenberger (Ohio); Alicia Lincoln, MSW, MSPH (Oklahoma); Kenneth Rosenberg, MD (Oregon); Tony Norwood (Pennsylvania); Sam Viner-Brown, PhD (Rhode Island); Mike Smith (South Carolina); Christine Rinki, MPH (South Dakota Tribal); Kate Sullivan, PhD (Texas); David Law, PhD (Tennessee); Laurie Baksh (Utah); Peggy Brozicevic (Vermont); Marilyn Wenner (Virginia); Linda Lohdefinck (Washington state); Melissa Baker, MA (West Virginia); Katherine Kvale, PhD (Wisconsin); Angi Crotsenberg (Wyoming); CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health.
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