title: Provision of specific preconception care messages and associated maternal health behaviors before and during pregnancy.
abstract: OBJECTIVE
  The purpose of this study was to examine the associations between receipt of specific preconception care messages before pregnancy and maternal behaviors before and during pregnancy.
  
  
  METHODS
  Data were from the Pregnancy Risk Assessment Monitoring System 2009-2010. Only women who reported receiving general preconception care were asked questions about specific health messages that they received before pregnancy (32.2% of the total sample; N = 10,267). Preconception care messages that were received and corresponding behaviors that were examined included taking vitamins with folic acid before pregnancy, dieting to lose weight or exercising before pregnancy (for women who were overweight or obese before pregnancy), and smoking and drinking alcohol during pregnancy (for women who reported smoking or alcohol use in the past 2 years). Separate weighted multivariable logistic regression models were used to assess the association between receipt of specific preconception care messages and maternal behaviors before and during pregnancy.
  
  
  RESULTS
  Women who reported receiving the message about taking vitamins with folic acid before pregnancy reported taking vitamins more often in the month before pregnancy compared with women who did not receive the message (77% vs 40%; P < .01; adjusted odds ratio [aOR], 2.99; 95% confidence interval [CI], 2.24-4.00). Among overweight and obese women, there was no difference in dieting or exercising between those who received the message about maintaining a healthy weight before pregnancy and those who did not (dieting: 41% vs 39% [P = .58; aOR, 1.06; 95% CI, 0.77-1.47]; exercising: 43% vs 40% [P = .42; aOR, 1.10; 95% CI, 0.81-1.51]). Among smokers, women who received the message regarding smoking during pregnancy smoked more often during the last 3 months of pregnancy than women who did not receive the message (47% vs 27%; P < .01; aOR, 2.22; 95% CI, 1.21-4.09). Among drinkers, the same percentage of women who did and did not receive the message about alcohol use during pregnancy drank in the last 3 months of pregnancy (13% vs 13%; P = .86; aOR, 0.95; 95% CI, 0.65-1.38).
  
  
  CONCLUSIONS
  Our study found that counseling on folic acid was associated with greater vitamin use, although counseling on dieting, exercising, drinking, and smoking among women who were at high risk was not associated with behaviors before or during pregnancy.
authors.affiliation: Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH.
authors.forename: Reena
authors.initials: R
authors.lastname: Oza-Frank
authors.affiliation: Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, OH. Electronic address: rashmi.kachoria@nationwidechildrens.org.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Kachoria
authors.affiliation: Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH; Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Keim
authors.affiliation: Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH; Department of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
mesh_terms: D000328:Adult; D037001:Directive Counseling; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008425:Maternal Behavior; D008429:Maternal Welfare; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D016742:Preconception Care / Q000379:methods*; D011247:Pregnancy / Q000523:psychology*; D011248:Pregnancy Complications / Q000517:prevention & control*; D057566:Self Report; D014481:United States
keywords: PRAMS; preconception care; pregnancy