The negative pregnancy test. An opportunity for preconception care.
OBJECTIVE
To identify women who would likely benefit from preconception care.


METHODS
A comprehensive preconception risk survey was administered during a structured interview to 136 women who had a negative pregnancy test visit in a family practice residency ambulatory practice. The survey solicited the presence of self-reported risk variables associated with maternal conditions related to poor obstetric outcome, risk factors for poor obstetric outcome, and risks for developing these conditions.


RESULTS
Seventy women (51.5%) reported a medical or reproductive risk that could adversely affect pregnancy. In addition, 68 women (50%) reported a genetic risk; 39 (28.7%) reported a risk for human immunodeficiency virus infection, 35 (25.7%) reported an indication for hepatitis B vaccine, and an equal number reported recent use of illegal substances; 23 (16.9%) reported at least one affirmative answer to the CAGE questionnaire; 79 (58.5%) smoked cigarettes; 74 (54.4%) reported a nutrition risk; 126 (92.6%) reported a psychosocial risk; and 39 (28.7%) reported a perceived barrier to ongoing medical care. Even with the psychosocial risk category excluded, 94% of the women still reported at least one factor requiring further evaluation, counseling, or intervention before pregnancy.


CONCLUSIONS
We discovered a significant number of women with obstetric risk factors. A negative pregnancy test visit provides an opportunity for preconception risk assessment and counseling. These results will guide us to further develop practical preconception care protocols.
Jack
B W
BW
Department of Family Medicine, Brown University School of Medicine, Providence, RI, USA.
Campanile
C
C
McQuade
W
W
Kogan
M D
MD
D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care; D016742:Preconception Care; D011247:Pregnancy; D011258:Pregnancy Tests; D012237:Rhode Island; D012307:Risk Factors