title: Determining Pre-Conception Risk Profiles Using a National Online Self-Reported Risk Assessment: A Cross-Sectional Study.
abstract: OBJECTIVE
  To measure the prevalence of health risk factors in women who are preparing for pregnancy, using an online publicly available questionnaire aimed at identifying personal and pre-conception risks and at providing tailored information.
  
  
  METHODS
  A nation-wide available, free, web-based, self-reported questionnaire for pre-conception use (in Dutch). Between May 2006 and August 2009, 89,946 questionnaires were completed (78,732 were from unique respondents) and available for research purposes, from which those of non-pregnant women (n = 66,617) were selected. Socio-demographic subgroups were distinguished by age, ethnicity, urban living area and living in a deprived neighbourhood. The four pre-conception risk domains were lifestyle, medical, reproductive and family history; together they were defining the risk profile. χ(2) tests were used to compare the risk profiles among the subgroups.
  
  
  RESULTS
  The prevalences of the reported risk factors are given. The risk factor profiles revealed that the average, responding, non-pregnant, Dutch woman is exposed to a substantial number of risk factors. Different risk profiles were observed in the different socio-demographic subgroups. Women older than 36 years, of non-Western origin, living in urban areas and those in deprived neighbourhoods showed higher risk profiles, based on a larger number of risks, with significantly higher prevalences.
  
  
  CONCLUSIONS
  Self-reported data from a large, self-selected, non-pregnant population who actively visited a web-site for reproductive information suggest the need for active general pre-conception care as risk factors were abundant. A considerable increase in attention for pre-conception care is justified; different subpopulations most likely require adapted approaches.
authors.affiliation: Division of Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Lena C A
authors.initials: LC
authors.lastname: Vink-van Os
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.forename: Elsbeth H
authors.initials: EH
authors.lastname: van Vliet-Lachotzki
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D020407:Internet; D008019:Life Style; D008423:Maternal Age; D008487:Medical History Taking; D009426:Netherlands; D011247:Pregnancy; D064186:Prenatal Education / Q000379:methods*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D014505:Urban Population