Routine pre-pregnancy health promotion for improving pregnancy outcomes

Whitworth, Melissa; Dowswell, Therese

doi:10.1002/14651858.cd007536

Cited by 41 publications

(22 citation statements)

References 9 publications

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“…18-23 PCC has shown promise in promoting healthy prepregnancy behaviors and even affecting birth outcomes in mothers with chronic disease. 24,25 However, though PCC is recommended for all women of childbearing age, 26 studies estimate that only 30% of women receive PCC during the 12 months before pregnancy. 13 …”

Section: Introductionmentioning

confidence: 99%

Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use

Bixenstine

Cheng

et al. 2015

Matern Child Health J

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Objective To examine the relationship between preconception counseling (PCC) on folic acid and folic acid use and reasons for non-use. Methods We analyzed Maryland Pregnancy Risk Assessment Monitoring System (PRAMS) survey responses from women with live births from 2009-2011. Multivariable weighted logistic regression models (n=4426) adjusting for maternal sociodemographics were used to explore the associations between PCC receipt and folic acid use and reasons for non-use. Results Less than 30% of women received folic acid PCC and only 32% of women took folic acid daily prepregnancy. The most common reasons for non-use were “not planning pregnancy” (61%) and “didn't think needed to take” (41%). PCC receipt was associated with three times the odds of folic acid use (adjusted odds ratio [aOR] 3.17, 95% CI 2.48-4.06) and half the odds of reporting “didn't think needed to take” (aOR 0.47, 95% CI 0.28-0.78) as a reason for non-use. Conclusions Folic acid use remains low. Folic acid PCC was associated with increased folic acid use but few women received it. Our data support initiatives to promote provision of folic acid PCC to all women of childbearing age.

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Section: Introductionmentioning

confidence: 99%

Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use

Bixenstine

Cheng

et al. 2015

Matern Child Health J

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“…The shift is also based on a growing body of evidence that women’s preconceptional health affects pregnancy-related outcomes including birthweight, fetal growth, and pregnancy weight gain and its sequelae (Institute of Medicine [IOM], 2009; Weisman et al, 2009, 2010). To date, however, few preconceptional interventions have been subjected to rigorous testing, and there is little evidence of the effectiveness of pre-pregnancy health promotion programs (Korenbrot, Steinberg, Bender, & Newberry, 2002; Wahabi, Alziedan, Bawazeer, Al-Ansary, & Esmaiel, 2010; Whitworth & Dowsell, 2009). …”

Section: Introductionmentioning

confidence: 99%

Improving Women’s Preconceptional Health: Long-Term Effects of the Strong Healthy Women Behavior Change Intervention in the Central Pennsylvania Women’s Health Study

Weisman

Hillemeier

Downs

et al. 2011

Women's Health Issues

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Purpose To investigate the long-term (6- and 12-month) effects of the Strong Healthy Women intervention on health-related behaviors, weight and body mass index (BMI), and weight gain during pregnancy. Strong Healthy Women is a small-group behavioral intervention for pre- and interconceptional women designed to modify key risk factors for adverse pregnancy outcomes; pretest–posttest findings from a randomized, controlled trial have been previously reported. The following questions are addressed: 1) were significant pretest–posttest changes in health-related behaviors (previously reported) maintained over the 12-month follow-up period; 2) did the intervention impact weight and BMI over the 12-month follow-up period; and 3) did the intervention impact pregnancy weight gain for those who gave birth during the follow-up period? Methods Data are from 6- and 12-month follow-up telephone interviews of women in the original trial of the Strong Healthy Women intervention (n = 362) and from birth records for singleton births (n = 45) during the 12-month follow-up period. Repeated measures regression was used to evaluate intervention effects. Main Findings At the 12-month follow-up, participants in the Strong Healthy Women intervention were significantly more likely than controls to use a daily multivitamin with folic acid and to have lower weight and BMI. The intervention’s effect on reading food labels for nutritional values dropped off between the 6- and 12-month follow-up. Among those who gave birth to singletons during the follow-up period, women who participated in the intervention had lower average pregnancy weight gain compared with controls. Although the intervention effect was no longer significant when controlling for pre-pregnancy obesity, the adjusted means show a trend toward lower weight gain in the intervention group. Conclusion These findings provide important evidence that the Strong Healthy Women behavior change intervention is effective in modifying important risk factors for adverse pregnancy outcomes and may improve an important pregnancy outcome, weight gain during pregnancy. Because the intervention seems to help women manage their weight in the months after the intervention and during pregnancy, it may be an effective obesity prevention strategy for women before, during, and after the transition to motherhood.

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“…Although routine preconception care, including reproductive life planning, could theoretically reduce unintended pregnancy and improve pregnancy and birth outcomes, there is very little research to date in this area. A 2009 Cochrane review concluded that, because of a paucity of research, there is little evidence for the effectiveness of prepregnancy health promotion (Whitworth & Dowswell, ). In the current climate of rising healthcare costs, there is growing pressure from both public and private sectors to establish evidence for the cost‐effectiveness and efficacy of interventions (Johnson et al., ).…”

Section: The Future Of Preconception Carementioning

confidence: 99%

The challenge of preconception counseling: Using reproductive life planning in primary care

Coffey¹,

Shorten²

2014

Journal of the American Association of Nurse Practitioners

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Purpose A case study is used to explore barriers and challenges in the delivery of preconception care, and to highlight the future role of reproductive life planning in primary practice settings. Data sources Peer‐reviewed journal articles and clinical practice guidelines pertaining to preconception care. Conclusions Because of the high rate of unintended pregnancy, preconception care should be incorporated into routine primary care for women of reproductive age. Reproductive life plans are tools that help formalize contraceptive and preconception care for women across the life span. They may prove particularly useful for women with chronic diseases and for young, low‐income, and minority women. Implications for practice With their emphasis on holistic care and patient education, nurse practitioners are well suited to incorporate elements of preconception care into the routine care they provide patients. Clinicians can modify reproductive life plans to fit the unique needs of an individual, patient population, or clinical practice.

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Routine pre-pregnancy health promotion for improving pregnancy outcomes

Cited by 41 publications

References 9 publications

Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use

Association Between Preconception Counseling and Folic Acid Supplementation Before Pregnancy and Reasons for Non-Use

Improving Women’s Preconceptional Health: Long-Term Effects of the Strong Healthy Women Behavior Change Intervention in the Central Pennsylvania Women’s Health Study

The challenge of preconception counseling: Using reproductive life planning in primary care

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