title: Effects of preconception counseling on maternal health care of migrant women in China: a community-based, cross-sectional survey.
abstract: BACKGROUND
  Migrants have long been a disadvantaged group in China's health care system, especially in terms of maternal health care. Many studies have explored the factors associated with a lack of maternal health care and found many determinants, including social, economic, behavioral, and environmental factors. However, studies focusing on factors associated with maternal health care have rarely examined preconception counseling (PCC). This study explored factors related to PCC uptake among migrant women, and investigated the association between PCC and maternal health care in migrant women.
  
  
  METHODS
  A community-based cross-sectional study was conducted from July to December 2011, in Nanhai, Guangdong Province, and Pinghu, Zhejiang Province, China. A total of 1,012 migrant women who had their most recent pregnancy within 1 year of the survey answered a standardized interviewer-administered questionnaire about maternal health care. Descriptive statistics and multivariable logistic regression were used to analyze the data.
  
  
  RESULTS
  Only 208 (20.6%, 95% confidence interval [CI]: 18.1-23.1%) of 1,012 migrant women had received PCC. Younger age, having more than one child, lack of knowledge of maternal health care and inter-province migration were predictors of a lack of PCC. PCC was associated with higher consumption of folic acid supplements during the preconception period (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.66-4.23). Among migrants who were resident in Nanhai or Pinghu for less than 5 years, PCC was related to better quality prenatal care (AOR = 3.07, 95% CI: 1.79-5.24).
  
  
  CONCLUSIONS
  The prevalence of PCC among migrant women was low (20.6%, 95% CI: 18.1-23.1%). Positive associations were found between the receipt of PCC and preconception folic acid supplements and quality prenatal care. Future studies focusing on maternal health care should pay attention to PCC and explore the effects of PCC on maternal health care through intervention studies. Continued efforts to increase PCC in migrants should target specific age groups (20-24 years), families with more than one child, and women who have migrated between provinces, as well as provide in-depth knowledge of maternal health care.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. 13111020023@fudan.edu.cn.
authors.forename: Xiaofang
authors.initials: X
authors.lastname: You
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. htan@fudan.edu.cn.
authors.forename: Hui
authors.initials: H
authors.lastname: Tan
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. hushiyun@yahoo.com.
authors.forename: Shiyun
authors.initials: S
authors.lastname: Hu
authors.affiliation: Pinghu Institute of Maternal and Child Health, Zhejiang Province, China. 1419390732@qq.com.
authors.forename: Jianmei
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. h_jiang@fudan.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. aipingpeng@163.com.
authors.forename: Aiping
authors.initials: A
authors.lastname: Peng
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. manaobei@163.com.
authors.forename: Yue
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. lingwang@fudan.edu.cn.
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.affiliation: United Nations Children's Fund China Country Office, Beijing, China. sguo@unicef.org.
authors.forename: Sufang
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai, 200032, People's Republic of China. xqian@fudan.edu.cn.
authors.forename: Xu
authors.initials: X
authors.lastname: Qian
mesh_terms: D000328:Adult; D002681:China; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D000068097:Maternal Health; D008427:Maternal Health Services / Q000592:standards / Q000706:statistics & numerical data*; D016017:Odds Ratio; D016742:Preconception Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D005492:Folic Acid