title: Health Behaviors Among Women Using Fertility Treatment.
abstract: Objective To describe associated perinatal behaviors among women using fertility treatment. Methods Data were obtained for 12,197 Maryland women who delivered live neonates from 2004 to 2011 and completed the Pregnancy Risk Assessment Monitoring System survey postpartum. We conducted weighted descriptive and multivariable analyses. Results Among 1368 women using fertility treatments, 28.4 % did not take folic acid daily 1 month before pregnancy, 58.1 % consumed alcohol, 16.0 % were binge drinking, and 7.5 % smoked 3 months before pregnancy, and 12.9 % consumed alcohol and 3.7 % smoked during pregnancy. Additionally, among those who consumed alcohol and smoked before pregnancy, 36.0 % and 25.7 %, respectively, reported not receiving prenatal counseling about alcohol use and smoking. Lack of counseling for these women was higher than for women with unintended pregnancies who consumed alcohol (36.0 % vs. 26.3 %, P < .001) or smoked (25.7 % vs. 15.0 %, P < .001). Women using fertility treatments were less likely to have inadequate folic acid intake [adjusted odds ratio (aOR) 0.14, 95 % confidence interval (CI) 0.10-0.18), consume alcohol (aOR 0.52, 95 % CI 0.40-0.69), and smoke (aOR 0.35, 95 % CI 0.21-0.59) before pregnancy, and no statistically significant differences were found during pregnancy for alcohol consumption (aOR 0.89, 95 % CI 0.59-1.33) or smoking (aOR 0.64, 95 % CI 0.28-1.45) compared to women with unintended pregnancies. Conclusion A significant proportion of women using fertility treatments were not practicing recommended perinatal behaviors or receiving prenatal counseling on preventable risk factors. Ongoing counseling before and during pregnancy may be especially effective for optimizing healthy behaviors among these motivated women undergoing often stressful treatments for fertility.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. holly.vo@ucsf.edu.|University of California, San Diego School of Medicine, 9500 Gilman Drive MC 0606, La Jolla, CA, 92093, USA. holly.vo@ucsf.edu.
authors.forename: Holly
authors.initials: H
authors.lastname: Vo
authors.affiliation: Maternal and Child Health Bureau, Maryland Department of Health and Mental Hygiene, 201 W. Preston Street, Room 313, Baltimore, MD, 21201, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Cheng
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Pediatrics, Johns Hopkins University School of Medicine, 1800 Orleans Street #8941, Baltimore, MD, 21287, USA.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Cheng
authors.affiliation: Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.|Agency for Healthcare Research and Quality, Office of Extramural Research, Education and Priority Populations, 5600 Fishers Lane, Room 06N03, Rockville, MD, 20857, USA.
authors.forename: Kamila B
authors.initials: KB
authors.lastname: Mistry
mesh_terms: D000328:Adult; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D015438:Health Behavior; D006801:Humans; D007231:Infant, Newborn; D007246:Infertility / Q000628:therapy*; D033182:Intention; D008396:Maryland / Q000453:epidemiology; D008425:Maternal Behavior / Q000523:psychology*; D011159:Population Surveillance; D011247:Pregnancy; D012959:Socioeconomic Factors
chemical_list: D005492:Folic Acid
keywords: Fertility treatment; PRAMS; Perinatal behaviors; Pregnancy intention; Preventable behaviors