RT Journal Article
SR Electronic
T1 Associations Between Modifiable Preconception Care Indicators and Pregnancy Outcomes
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 84
OP 93
DO 10.3122/jabfm.2024.240133R1
VO 38
IS 1
A1 Kamath Mulki, Ashwini
A1 Johnson, Melanie B.
A1 Burgess, Nicole M.
A1 Shaak, Kyle
A1 Nisbett, Katie
A1 Jabbour, Katarzyna
A1 Hamadani, Roya
A1 Careyva, Beth
YR 2025
UL http://www.jabfm.org/content/38/1/84.abstract
AB Purpose: This study explored gaps and opportunities in preconception care with a focus on determining whether modifiable preconception care indicators are associated with preterm births.Methods: This retrospective case-control study explored prepregnancy data of patients ≥18 years old who delivered preterm (cases) versus full term (controls) between June 1, 2018, and May 31, 2019, at a health care network in Pennsylvania. Cases were matched 1:2 with controls based on age, parity, and history of preterm delivery. A literature review yielded 11 key indicators of quality preconception care. Documentation of counseling on these indicators were extracted from patient charts from their most recent primary care visit before pregnancy (preconception care) and their pregnancy intake visit (prenatal care). Bivariate analyses were used to assess whether any of the 11 preconception indicators were associated with preterm birth. All analyses were conducted using SPSS statistical software.Results: Our sample included 663 patient charts: 221 preterm births and 442 term births. Elevated blood pressure (>120/80) in the preconception period (Odds Ratio [OR] = 1.84) and at the prenatal intake visit (OR = 1.68) was significantly associated with preterm birth. In addition, patients with Body Mass Index (BMI) ≤18 or ≥30 at their prenatal visit were nearly twice as likely (OR = 1.85) to have pregnancies resulting in preterm birth.Conclusions: Our study highlights BMI and Blood Pressure (BP) as key focus points for preconception counseling. Additional studies are needed to determine whether pregnancy outcomes other than preterm birth may be influenced by these and other preconception care indicators.