Preconception health behaviors among women with planned pregnancies

A cross-sectional study with a probabilistic sample of 264 women between 18 and 49 years of age who had or were undergoing planned pregnancies, and were users of two School Health Centers in the city of São Paulo. Analysis was conducted through univariate and multiple logistic regression of three variable blocks: 1) social and demographic characteristics; 2) sexual and reproductive characteristics; 3) preexisting health conditions.

Results:

Women with higher education, belonging to economic groups A and B, and older women with infertility were more likely to perform preconception training.

Conclusion:

Preconception care has a strong social determination, as women with more favorable social profiles are more likely to perform it. Experience with infertility is also instrumental in the likelihood of preconception care.

Descriptors:
Preconception Care; Pregnancy; Women; Sexual and Reproductive Health; Maternal-Child Nursing

Variable	Avg.		SD		Median	Min.	Max
Age (years)	32.135.7		5.36.8		32	20	43
Age of partner (years)	32.135.7		5.36.8		36	22	68
Variable	Performed or performs preconception care
	No		Yes				p *value^ * Chi-square test;**
	n	%	n	%	n	%	p *value^ * Chi-square test;**
Age
18 to 24 years	19	19.0	7	4.3	26	9.8	<0.001
25 to 29 years	33	33.0	24	14.6	57	21.6
30 to 34 years	26	26.0	60	36.6	86	32.6
35 years old or more	22	22.0	73	44.5	95	36.0
Paid work
No	44	44.0	51	31.1	95	36.0	0.034
Yes	56	56.0	113	68.9	169	64.0
Lives with partner
No	6	6.0	4	2.4	10	3.8	0.142
Yes	94	94.0	160	97.6	254	96.2
Economic classification^ Variables missing (answers not a 100% complete);
A and B	49	49.5	132	82.5	181	69.2	<0.001
C and D^* ***** The 'E' economic classification was not considered.	50	50.5	28	17.5	78	30.1
Has a health insurance
No	69	69.0	62	37.8	131	49.6	<0.001
Yes	31	31.0	102	62.2	133	50.4
Educational level
Elementary school	19	19.0	10	6.1	29	11.0	<0.001
Middle school	52	52.0	50	30.5	102	38.6
Superior or more	29	29.0	104	63.4	133	50.4
Total	100	100	164	100	264	100

Variable	Avg.	SD		Median		Min.	Máx.
Age at 1st intercourse (years)	18.0	2.9		18		11	30
Age at first pregnancy (years)	26.4	6.7		26		14	42
Variable	Performed or performs preconception care
	No		Yes		Total		*p value^ * Chi-square test;**
	n	%	n	%	n	%	*p value^ * Chi-square test;**
Age at first intercourse (years)^ Variables missing (answers not a 100% complete).
11 to 19 years	87	87.0	118	72.4	205	77.9	0.006
20 years old or more	13	13.0	45	27.6	58	22.1
Age at first pregnancy (years)
14 to 19	30	30.0	19	11.6	49	18.6	<0.001
20 to 24	25	25.0	31	18.9	56	21.2
25 to 29 years	29	29.0	33	20.1	62	23.5
30 years old or more	16	16.0	81	49.4	97	36.7
Number of pregnancies
One	38	38.0	70	42.7	108	40.9	0.295
Two	46	46.0	60	36.6	106	40.2
Three or more	16	16.0	34	20.7	50	18.9
Number of children^ Variables missing (answers not a 100% complete).
None	5	5.1	7	4.3	12	4.6	0.557
One	45	45.4	89	54.3	134	50.9
Two	41	41.4	55	33.5	96	36.5
Three or more	8	8.1	13	7.9	21	8.0
Previous abortion
No	83	83.0	126	76.8	209	79.2	0.231
Yes	17	17.0	28	23.2	55	20.8
Total	100	100	164	100	264	100

Variable	Performed or performs preconception care
	No		Yes		Total		p value^* * Chi-square test;
	n	%	n	%	n	%	p value^* * Chi-square test;
Infertility^ Variables missing (answers not a 100% complete).
No	90	91.8	132	81.9	222	85.7	0.028
Yes	8	8.0	29	18.1	37	14.3
Preexisting disease before pregnancy
No	84	84.0	114	69.5	198	75.0	0.008
Yes	16	16.0	50	30.5	66	25.0
Use of tobacco, alcohol and other drugs before pregnancy
No	59	59.0	110	67.1	169	64.0	0.185
Yes	41	41.0	54	32.9	95	36.0
Outside of normal weight before pregnancy^ Variables missing (answers not a 100% complete).
No	56	56.0	90	54.9	146	55.3	0.409
Yes	42	42.0	74	45.1	116	43.9
History of genetic disease
No	91	91.0	148	90.2	239	90.5	0.839
Yes	9	9.0	16	9.8	25	9.5
Use of medications and treatment performed before pregnancy
No	91	91.0	121	73.8	212	80.3	0.001
Yes	9	9.0	43	26.2	52	19.7
Consanguinity among partners
No	97	97.0	160	97.6	257	97.3	0.783
Yes	3	3.0	4	2.4	7	2.7
Total	100	100.0	164	100.0	264	100.0

Block I - social and demographic variables	Univariate		Multiple
Block I - social and demographic variables	Gross OR	CI 95%	Adj. OR	CI 95%
Age (years)
18 to 24 years	1	-	1	-
25 to 29 years	2.0	0.71-5.43	2.1	0.68-6.35
30 to 34 years	6.3	2.34-16.70	4.5	1.50-13.45
≥ 35 years old	9.0	3.34-24.21	5.4	1.78-16.57
Paid work
No	1	-	1	-
Yes	1.7	1.04-2.91	1.3	0.7-2.34
Economic classification
A and B	1	-	1	-
C and D	0.2	0.11-0.36	0.5	0.22-0.94
Educational level
Primary school	1	-	1	-
Middle school	1.8	0.77-4.31	1.7	0.64-4.49
Superior	6.8	2.85-16.25	3.1	1.04-8.96
Block II - sexual and reproductive variables	Univariate		Multiple
Block II - sexual and reproductive variables	Gross OR	CI 95%	Adj. OR	CI 95%
Age at first sexual intercourse
11 to 19 years	1	-	-	-
≥ 20 years old	2.5	1.29-5.01	-	-
Number of children
None	1	-	-	-
One	1.4	0.42-4.70	-	-
Two	1	0.28-3.23	-	-
Three or more	1.2	0.27-4.93	-	-
Block III -preexisting conditions	Univariate		Multiple
Block III -preexisting conditions	Gross OR	CI 95%	Adj. OR	CI 95%
Preexisting diseases
No	1	-	1	-
Yes	2.3	1.22-4.32	2.4	1.17-4.34
Use of tobacco, alcohol and other drugs
No	1	-	-	-
Yes	0.7	0.42-1.18	-	-
Infertility
No	1	-	1	-
Yes	2.5	1.08-5.65	2.4	1.02-5.51

Variable	Category	Multiple
Variable	Category	OR ajust	IC 95%
Age	18 to 24 years	1.0	-
	25 to 29 years	2.4	0.73-8.19
	30 to 34 years	5.5	1.68-17.87
	≥ 35 years old	5.7	1.71-18.69
Economic classification	A and B	1.0	-
	C and D	0.4	0.20-0.94
Educational level	Primary school	1.0	-
	Middle school	2.4	0.83-7.08
	Superior	4.4	1.35-14.29
Preexisting diseases	No	1.0	-
	Yes	2.0	0.93-4.29
Infertility	No	1.0	-
	Yes	2.8	1.04-7.72
Age at first sexual intercourse	11 to 19 years	1.0	-
	≥ 20 years old	1.5	0.71-3.33

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[1] Corresponding Author: Natália de Castro Nascimento. E-mail: natalia.castro.nascimento@usp.br