Abstract
Objectives This study aimed to understand the impact of a previous adverse infant outcome (AIO) on use of preconception care prior to a subsequent pregnancy. Methods Responses from the 2010 and 2012 Los Angeles Mommy and Baby Surveys were analyzed. Weighted multivariate logistic regression was employed to identify significant associations between having had a previous AIO (preterm delivery, low birth weight infant, stillbirth, or major birth defect) and receipt of preconception care prior to the most recent pregnancy. Select patient-level covariates were included: chronic disease, age, education level, race/ethnicity, country of birth, insurance status prior to pregnancy and pregnancy intent. Adjustment for missing responses was performed using multiple chained imputation. Results After controlling for covariates, having had a previous AIO was associated with an increased odds of having utilized preconception care in the most recent pregnancy (OR 1.237, p = 0.040). Per the final regression model, a woman reporting a previous AIO and an intended subsequent pregnancy had a 42.4 % likelihood of having used preconception care. Of these women, only 28.8 % reported doing so because of concern regarding a previous birth complication. Discussion Women reporting a previous AIO were more likely to have used preconception care in a subsequent pregnancy. The prevalence of preconception care utilization remained low overall. Pregnancy intent emerged as a strong secondary predictor; any concerted strategy to improve access to preconception care must include initiatives to help ensure that pregnancies are planned.
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Acknowledgments
The 2010 and 2012 LAMB Surveys were supported by grants from the State of California Department of Public Health—Maternal, Child, and Adolescent Health Branch—through the Los Angeles County Department of Public Health and First 5 LA. This study was supported by funding from the Robert Wood Johnson Foundation (Grant #71897)
Author Contributions
Dr. Batra designed the study, carried out the analyses, drafted and revised the manuscript, and approved the final manuscript as submitted. Ms. Higgins coordinated data collection for the 2010 and 2012 LAMB surveys, assisted in the design of the study, and approved the final manuscript as submitted. Dr. Chao supervised the operation of the 2010 and 2012 LAMB surveys, assisted in design of the study, assisted with analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted.
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All LAMB Survey respondents provided informed consent for participation. The analyses presented here utilized de-identified LAMB Survey data. This study was reviewed by the Institutional Review Boards of the California Department of Public Health (Protocol ID 14-11-1782) and the University of California, Los Angeles (Protocol ID 14-001748).
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Batra, P., Higgins, C. & Chao, S.M. Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys. Matern Child Health J 20, 1170–1177 (2016). https://doi.org/10.1007/s10995-015-1904-x
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DOI: https://doi.org/10.1007/s10995-015-1904-x