Preconception care: a screening tool for health assessment and risk detection.
BACKGROUND
Identification of risk factors for adverse pregnancy outcome is a main component of preconception care, but requires adequate time and knowledge. This study compares self-administered questionnaires to history taking by a physician to evaluate the reliability of such a screening tool for prepregnancy risk detection.


METHODS
One hundred ninety-three women from the outpatient clinic of Obstetrics and Gynecology of the University Medical Center Nijmegen, The Netherlands, were included in a study on preconception care. A Preconceptional Health Assessment form with risk variables pertaining to social, nutritional, medical, infectious disease, medication, reproductive and family history, and two Family History surveys (for the woman and her partner) were completed by 186 couples at home. A physician then orally verified the written answers. Agreement between the written and the oral answers was calculated using kappa statistic.


RESULTS
An excellent agreement level was found for all sections of the Preconceptional Health Assessment form (overall kappa = 0.88) except for nutritional history (kappa = 0.70). The Family History surveys also showed a high agreement level (kappa = 0.92 for women and kappa = 0.90 for men).


CONCLUSIONS
The questionnaires are an accurate screening tool for preconceptional risk factors. We advocate their implementation in various settings to facilitate the provision of preconception care.
de Weerd
Sabina
S
Department of Obstetrics and Gynecology, University Medical Center Nijmegen, The Netherlands.
van der Bij
Akke K
AK
Cikot
Rolf J L M
RJ
Braspenning
Jozé C C
JC
Braat
Didi D M
DD
Steegers
Eric A P
EA
D000328:Adult; D003376:Counseling; D005260:Female; D006304:Health Status; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008487:Medical History Taking; D015596:Nutrition Assessment; D016742:Preconception Care / Q000379:methods*; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016387:Women's Health