title: Associations between preconception counseling and maternal behaviors before and during pregnancy.
abstract: 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.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-22, Atlanta, GA 30341-3724, USA. LMWilliams@cdc.gov
authors.forename: Letitia
authors.initials: L
authors.lastname: Williams
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Zapata
authors.forename: Denise V
authors.initials: DV
authors.lastname: D'Angelo
authors.forename: Leslie
authors.initials: L
authors.lastname: Harrison
authors.forename: Brian
authors.initials: B
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D016001:Confidence Intervals; D003376:Counseling / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008425:Maternal Behavior; D016017:Odds Ratio; D011159:Population Surveillance; D016742:Preconception Care / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods*; D018570:Risk Assessment; D012648:Self Care / Q000379:methods; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult