Predictors of Preconception Care Reception in a Sample of Iranian Pregnant
Women Referred to Qazvin Health Centers

Nasim      Bahrami; Kelly-Ann      Allen; Zainab      Alimoardi

doi:10.2174/1573404819666220620091743

Abstract

Background: Preconception care (PCC) is one of the most important components of healthcare services for women of reproductive age. Focusing on improving preconception health can lead to improved reproductive outcomes, healthier pregnancies, and healthier babies.

Aims: The aim of the study was to determine the predictive factors of receiving PCC in pregnant women of Qazvin.

Methods: The present cross-sectional study was conducted from March 2018 to September 2019. Participants included 350 pregnant women in their 6-14 weeks of gestation, who had been referred to a selected comprehensive health center (CHC) for their initial prenatal visits. A two-stage cluster sampling was used to access the samples with maximum socioeconomic and cultural diversity. Data were collected using a questionnaire on demographics, fertility, and factors that affect access to PCC; a questionnaire on perceived social support; and a general self-efficacy questionnaire. Data were analyzed using uni-variable and multivariable logistic regression methods with SPSS software version 25.

Results: In the present study, 57.5% of the participants had received PCC. More than 75% of them received this care less than a year ago at a CHC. In the final model, wanted pregnancy (OR= 11.68), awareness of PCC (OR= 8.86), and history of ART for current pregnancy (OR= 7.18) were the strongest predictors for PCC reception.

Conclusion: Women of reproductive age appear to benefit strongly from PCC services when they have planned their pregnancy and are aware of PCC services. Therefore, information related to the opportunities and potential outcomes of PCC should be made publicly available. In addition, healthcare providers should focus more on providing patients with information about preconception counseling.

Keywords: Preconception counseling, predictors, logistic regression, cross-sectional, pregnancy outcomes, abortion

Graphical Abstract

[1]
Bayrami, R.; Ebrahimipour, H.; Ebrahimi, M.; Forootani, M.; Najafzadeh, B. Health care provider s′ knowledge, attitude and practice regarding pre-conception care. J. Res. Heal.,  2013, 3(4), 519-526.

[2]
Cunningham, F.G. Williams Obstetrics, 24th ed; McGraw-Hill Education, 2014. 

[3]
Mittal, P.; Dandekar, A.; Hessler, D. Use of a modified reproductive life plan to improve awareness of preconception health in women with chronic disease. Perm. J.,  2014, 18(2), 28-32.
 [http://dx.doi.org/10.7812/TPP/13-146] [PMID:  24867547]

[4]
Coffey, K.; Shorten, A. The challenge of preconception counseling: Using reproductive life planning in primary care. J. Am. Assoc. Nurse Pract.,  2014, 26(5), 255-262.
 [http://dx.doi.org/10.1002/2327-6924.12054] [PMID:  24170712]

[5]
Wally, M.K.; Huber, L.R.B.; Issel, L.M.; Thompson, M.E. The association between preconception care receipt and the timeliness and adequacy of prenatal care: An examination of multistate data from pregnancy risk assessment monitoring system (PRAMS) 2009-2011. Matern. Child Health J.,  2018, 22(1), 41-50.
 [http://dx.doi.org/10.1007/s10995-017-2352-6] [PMID:  28752273]

[6]
Fuehrer, L.; Buckler, E.; Bowman, E.; Gregory, T.; McDaniel, J. Promoting preconception health in primary care. JAAPA,  2015, 28(8), 27-32.
 [http://dx.doi.org/10.1097/01.JAA.0000469436.52325.cb] [PMID:  26164048]

[7]
Atrash, H.K.; Johnson, K.; Adams, M.; Cordero, J.F.; Howse, J. Preconception care for improving perinatal outcomes: The time to act. Matern. Child Health J.,  2006, 10(5)(Suppl.), S3-S11.
 [http://dx.doi.org/10.1007/s10995-006-0100-4] [PMID:  16773452]

[8]
Korenbrot, C.C.; Steinberg, A.; Bender, C.; Newberry, S. Preconception care: A systematic review. Matern. Child Health J.,  2002, 6(2), 75-88.
 [http://dx.doi.org/10.1023/A:1015460106832] [PMID:  12092984]

[9]
Parhizkar, A.; Sahsavari, S. Comparison of infants’ growth indicators in wanted and unwanted pregnancy at health centers of Sanandaj in 2014-2015. Iran. J. Obstet. Gynecol. Infert.,  2016, 19(11), 11-17.

[10]
Arluck, J.C.; Mayhew, A.C. Preconception care for the general ob/gyn. Clin. Obstet. Gynecol.,  2018, 61(1), 62-71.
 [http://dx.doi.org/10.1097/GRF.0000000000000338] [PMID:  29319589]

[11]
Chuang, C.H.; Velott, D.L.; Weisman, C.S. Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Matern. Child Health J.,  2010, 14(5), 713-719.
 [http://dx.doi.org/10.1007/s10995-009-0518-6] [PMID:  19760164]

[12]
Roberts, J.M.; Pearson, G.D.; Cutler, J.A.; Lindheimer, M.D. Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertens. Pregnancy,  2003, 22(2), 109-127.
 [http://dx.doi.org/10.1081/PRG-120016792] [PMID:  12908996]

[13]
Stothard, K.J.; Tennant, P.W.; Bell, R.; Rankin, J. Maternal overweight and obesity and the risk of congenital anomalies: A systematic review and meta-analysis. JAMA,  2009, 301(6), 636-650.
 [http://dx.doi.org/10.1001/jama.2009.113] [PMID:  19211471]

[14]
Casey, B.M.; Dashe, J.S.; Wells, C.E.; McIntire, D.D.; Byrd, W.; Leveno, K.J.; Cunningham, F.G. Subclinical hypothyroidism and pregnancy outcomes. Obstet. Gynecol.,  2005, 105(2), 239-245.
 [http://dx.doi.org/10.1097/01.AOG.0000152345.99421.22] [PMID:  15684146]

[15]
Lassi, Z.S.; Imam, A.M.; Dean, S.V.; Bhutta, Z.A. Preconception care: Screening and management of chronic disease and promoting psychological health. Reprod. Health,  2014, 11(3)(Suppl. 3), S5.
 [http://dx.doi.org/10.1186/1742-4755-11-S3-S5] [PMID:  25415675]

[16]
Cohen, J.A. Treating traumatized children: Current status and future directions. J. Trauma Dissociation,  2005, 6(2), 109-121.
 [http://dx.doi.org/10.1300/J229v06n02_10] [PMID:  16150673]

[17]
Burt, S.A.; McGue, M.; Krueger, R.F.; Iacono, W.G. How are parent-child conflict and childhood externalizing symptoms related over time? Results from a genetically informative cross-lagged study. Dev. Psychopathol.,  2005, 17(1), 145-165.
 [http://dx.doi.org/10.1017/S095457940505008X] [PMID:  15971764]

[18]
Halbreich, U. The association between pregnancy processes, preterm delivery, low birth weight, and postpartum depressions-the need for interdisciplinary integration. Am. J. Obstet. Gynecol.,  2005, 193(4), 1312-1322.
 [http://dx.doi.org/10.1016/j.ajog.2005.02.103] [PMID:  16202720]

[19]
Delissaint, D.; McKyer, E.L.J. A systematic review of factors utilized in preconception health behavior research. Health Educ. Behav.,  2011, 38(6), 603-616.
 [http://dx.doi.org/10.1177/1090198110389709] [PMID:  21511954]

[20]
Temel, S.; van Voorst, S.F.; Jack, B.W. Denktaş, S.; Steegers, E.A. Evidence-based preconceptional lifestyle interventions. Epidemiol. Rev.,  2014, 36(1), 19-30.
 [http://dx.doi.org/10.1093/epirev/mxt003] [PMID:  23985430]

[21]
Steel, A.; Lucke, J.; Adams, J. The prevalence and nature of the use of preconception services by women with chronic health conditions: An integrative review. BMC Womens Health,  2015, 15(1), 14.
 [http://dx.doi.org/10.1186/s12905-015-0165-6] [PMID:  25783639]

[22]
Johnson, K.; Posner, S.F.; Biermann, J.; Cordero, J.F.; Atrash, H.K.; Parker, C.S.; Boulet, S.; Curtis, M.G. Recommendations to improve preconception health and health care-United States. A report of the CDC/ATSDR preconception care work group and the select panel on preconception care. MMWR Recomm. Rep.,  2006, 55(RR-6), 1-23.
 [PMID:  16617292]

[23]
Nepali, G.; Sapkota, S.D. Knowledge and practice regarding preconception care among antenatal mothers. Int. J. Percept. Public Health,  2017, 1(4), 224-227.

[24]
Ekem, N.N.; Lawani, L.O.; Onoh, R.C.; Iyoke, C.A.; Ajah, L.O.; Onwe, E.O.; Onyebuchi, A.K.; Okafor, L.C. Utilisation of preconception care services and determinants of poor uptake among a cohort of women in Abakaliki Southeast Nigeria. J. Obstet. Gynaecol.,  2018, 38(6), 739-744.
 [http://dx.doi.org/10.1080/01443615.2017.1405922] [PMID:  29526148]

[25]
Gautan, P.; Dhakal, R. Knowledge on preconception care among reproductive age women. Saudi J. Med. Pharm. Sci.,  2016, 2(1), 6.

[26]
Poels, M.; Koster, M.P.; Boeije, H.R.; Franx, A.; van Stel, H.F. Why do women not use preconception care? A systematic review on barriers and facilitators. Obstet. Gynecol. Surv.,  2016, 71(10), 603-612.
 [http://dx.doi.org/10.1097/OGX.0000000000000360] [PMID:  27770130]

[27]
Population FaSHO; Office MH. Performance and achievement report of maternal death care national system. 2016.

[28]
Khanjari, S.; Molla, F.; Hosseini, F.; Faragollahi, M. Prenatal care utilization and factors affecting to receive prenatal care from clients’ perspectives. Iran J. Nurs.,  2006, 19(45), 37-48.

[29]
Kharazi, S.S.; Peyman, N.; Esmaily, H. Effect of an educational intervention based on self-efficacy theory and health literacy strategies on pregnancy outcomes: A randomized clinical trial. Iran. J. Obstet. Gynecol. Infert.,  2018, 21(5), 33-46.

[30]
Saraian, E.; Sajjadian, I. Comparison of perceived social support and psychological well-being between pregnant women with surrogacy, assisted reproductive technology (ART) and natural fertility. Iran. J. Psychiatr. Nurs.,  2016, 4(2), 1-10.
 [http://dx.doi.org/10.21859/ijpn-04021]

[31]
Frey, K.A.; Files, J.A. Preconception healthcare: What women know and believe. Matern. Child Health J.,  2006, 10(5)(Suppl.), S73-S77.
 [http://dx.doi.org/10.1007/s10995-006-0110-2] [PMID:  16775757]

[32]
Tokunbo, O.A.; Abimbola, O.K.; Polite, I.O.; Gbemiga, O.A. Awareness and perception of preconception care among health workers in Ahmadu Bello University teaching university, Zaria. Trop. J. Obstet. Gynaecol.,  2016, 33(2), 149-152.
 [http://dx.doi.org/10.4103/0189-5117.192215]

[33]
Shannon, G.D.; Alberg, C.; Nacul, L.; Pashayan, N. Preconception healthcare delivery at a population level: Construction of public health models of preconception care. Matern. Child Health J.,  2014, 18(6), 1512-1531.
 [http://dx.doi.org/10.1007/s10995-013-1393-8] [PMID:  24234279]

[34]
Tuomainen, H.; Cross-Bardell, L.; Bhoday, M.; Qureshi, N.; Kai, J. Opportunities and challenges for enhancing preconception health in primary care: Qualitative study with women from ethnically diverse communities. BMJ Open,  2013, 3(7), e002977.
 [http://dx.doi.org/10.1136/bmjopen-2013-002977] [PMID:  23883884]

[35]
Mazza, D.; Chapman, A. Improving the uptake of preconception care and periconceptional folate supplementation: What do women think? BMC Public Health,  2010, 10(1), 786.
 [http://dx.doi.org/10.1186/1471-2458-10-786] [PMID:  21182797]

[36]
Zimet, G.D.; Powell, S.S.; Farley, G.K.; Werkman, S.; Berkoff, K.A. Psychometric characteristics of the multidimensional scale of perceived social support. J. Pers. Assess.,  1990, 55(3-4), 610-617.
 [http://dx.doi.org/10.1080/00223891.1990.9674095] [PMID:  2280326]

[37]
Bruwer, B.; Emsley, R.; Kidd, M.; Lochner, C.; Seedat, S. Psychometric properties of the multidimensional scale of perceived social support in youth. Compr. Psychiatry,  2008, 49(2), 195-201.
 [http://dx.doi.org/10.1016/j.comppsych.2007.09.002] [PMID:  18243894]

[38]
Salimi, A.; Joukar, B.; Nikpour, R. Internet and communication: Perceived social support and loneliness as antecedent variables. Psychol. Stud.,  2009, 5(3), 81-102.

[39]
Sherer, M.; Maddux, J.E.; Mercandante, B.; Prentice-Dunn, S.; Jacobs, B.; Rogers, R.W. The self-efficacy scale: Construction and validation. Psychol. Rep.,  1982, 51(2), 663-671.
 [http://dx.doi.org/10.2466/pr0.1982.51.2.663] [PMID:  7089151]

[40]
Arabian, A.; Khodapanahi, M.K.; Heydari, M.; Saleh, S.B. Relationships between self-efficacy beliefs, mental health and academic achievement in colleagues. J. Psychol.,  2005, 8(4), 360-371.

[41]
Tripathi, A.; Rankin, J.; Aarvold, J.; Chandler, C.; Bell, R. Preconception counseling in women with diabetes. A population-based study in the north of England. Diabetes Care,  2010, 33(3), 586-588.

[42]
Williams, L.; Zapata, L.B.; D’Angelo, D.V.; Harrison, L.; Morrow, B. Associations between preconception counseling and maternal behaviors before and during pregnancy. Matern. Child Health J.,  2012, 16(9), 1854-1861.
 [http://dx.doi.org/10.1007/s10995-011-0932-4] [PMID:  22173331]

[43]
ShamshiriMilani, H.; Khazaie, F.; Rassouli, M.; Ramezankhani, A. Explanation of women’s and family health care personnel’s perception of the barriers of pre-pregnancy care coverage: A qualitative study. J. Health Field,  2016, 1(3), 18-27.

[44]
Bortolus, R.; Oprandi, N.C.; Rech Morassutti, F.; Marchetto, L.; Filippini, F.; Agricola, E.; Tozzi, A.E.; Castellani, C.; Lalatta, F.; Rusticali, B.; Mastroiacovo, P. Why women do not ask for information on preconception health? A qualitative study. BMC Pregnancy Childbirth,  2017, 17(1), 5.
 [http://dx.doi.org/10.1186/s12884-016-1198-z] [PMID:  28056865]

[45]
M’hamdi, H.I.; van Voorst, S.F.; Pinxten, W.; Hilhorst, M.T.; Steegers, E.A. Barriers in the uptake and delivery of preconception care: Exploring the views of care providers. Matern. Child Health J.,  2017, 21(1), 21-28.
 [http://dx.doi.org/10.1007/s10995-016-2089-7] [PMID:  27423236]

[46]
Fransen, M.P.; Hopman, M.E.; Murugesu, L.; Rosman, A.N.; Smith, S.K. Preconception counselling for low health literate women: An exploration of determinants in the Netherlands. Reprod. Health,  2018, 15(1), 192.
 [http://dx.doi.org/10.1186/s12978-018-0617-1] [PMID:  30470239]

[47]
Kassa, A.; Human, S.; Gemeda, H. Level of healthcare Providers’ Preconception Care (PCC) practice and factors associated with non-implementation of PCC in Hawassa, Ethiopia. Ethiop. J. Health Sci.,  2019, 29(1), 903-912.
 [PMID:  30700958]

[48]
Norman, C.D. Social media and health promotion; Sage Publications Sage UK: London, England, 2012, pp. 3-6.

[49]
Stellefson, M.; Paige, S.R.; Chaney, B.H.; Chaney, J.D. Evolving role of social media in health promotion: Updated responsibilities for health education specialists. Int. J. Environ. Res. Public Health,  2020, 17(4), 1153.
 [http://dx.doi.org/10.3390/ijerph17041153] [PMID:  32059561]

[50]
Kubheka, B.Z.; Carter, V.; Mwaura, J. Social media health promotion in South Africa: Opportunities and challenges. Afr. J. Prim. Health Care Fam. Med.,  2020, 12(1), e1-e7.
 [http://dx.doi.org/10.4102/phcfm.v12i1.2389] [PMID:  32787400]

[51]
Schillinger, D.; Chittamuru, D. Ramírez, A.S. From “infodemics” to health promotion: A novel framework for the role of social media in public health. Am. J. Public Health,  2020, 110(9), 1393-1396.
 [http://dx.doi.org/10.2105/AJPH.2020.305746] [PMID:  32552021]

[52]
Borges, A.L.V.; Santos, O.A. Nascimento, Nde.C.; Chofakian, C.B.; Gomes-Sponholz, F.A. Preconception health behaviors associated with pregnancy planning status among Brazilian women. Rev. Esc. Enferm. USP,  2016, 50(2), 208-216.
 [http://dx.doi.org/10.1590/S0080-623420160000200005] [PMID:  27384199]

[53]
Sedlecky, K. Stanković, Z. Contraception for adolescents after abortion. Eur. J. Contracept. Reprod. Health Care,  2016, 21(1), 4-14.
 [http://dx.doi.org/10.3109/13625187.2015.1082175] [PMID:  26463183]

[54]
Lipsky, L.M.; Strawderman, M.S.; Olson, C.M. Weight-related self-efficacy in relation to maternal body weight from early pregnancy to 2 years post-partum. Matern. Child Nutr.,  2016, 12(3), 569-578.
 [http://dx.doi.org/10.1111/mcn.12149] [PMID:  25244078]

[55]
Hinton, P.S.; Olson, C.M. Predictors of pregnancy-associated change in physical activity in a rural white population. Matern. Child Health J.,  2001, 5(1), 7-14.
 [http://dx.doi.org/10.1023/A:1011315616694] [PMID:  11341722]

[56]
Hinton, P.S.; Olson, C.M. Postpartum exercise and food intake: The importance of behavior-specific self-efficacy. J. Am. Diet. Assoc.,  2001, 101(12), 1430-1437.
 [http://dx.doi.org/10.1016/S0002-8223(01)00345-5] [PMID:  11762738]

[57]
Langenberg, P.; Ballesteros, M.; Feldman, R.; Damron, D.; Anliker, J.; Havas, S. Psychosocial factors and intervention-associated changes in those factors as correlates of change in fruit and vegetable consumption in the Maryland WIC 5 A day promotion program. Ann. Behav. Med.,  2000, 22(4), 307-315.

[58]
Kendall, A.; Olson, C.M.; Frongillo, Jr, E.A. Evaluation of psychosocial measures for understanding weight-related behaviors in pregnant women. Ann. Behav. Med.,  2001, 23(1), 50-58.
 [http://dx.doi.org/10.1207/S15324796ABM2301_8]

[59]
Araban, M.; Karimian, Z.; Karimian Kakolaki, Z.; McQueen, K.A.; Dennis, C-L. Randomized controlled trial of a prenatal breastfeeding self-efficacy intervention in primiparous women in Iran. J. Obstet. Gynecol. Neonatal Nurs.,  2018, 47(2), 173-183.
 [http://dx.doi.org/10.1016/j.jogn.2018.01.005] [PMID:  29406289]

[60]
Tilden, E.L.; Caughey, A.B.; Lee, C.S.; Emeis, C. The effect of childbirth self-efficacy on perinatal outcomes. J. Obstet. Gynecol. Neonatal Nurs.,  2016, 45(4), 465-480.
 [http://dx.doi.org/10.1016/j.jogn.2016.06.003] [PMID:  27290918]

Rights & Permissions Print Cite

Article Metrics

1

Journal Information

For Authors

For Editors

For Reviewers

Explore Articles

Open Access

Open Access Articles

For Visitors

DOI https://dx.doi.org/10.2174/1573404819666220620091743	Print ISSN 1573-4048
Publisher Name Bentham Science Publisher	Online ISSN 1875-6581

Current Women`s Health Reviews

Predictors of Preconception Care Reception in a Sample of Iranian Pregnant Women Referred to Qazvin Health Centers

Abstract Play Pause

Graphical Abstract

Abstract