Operationalization of Preconception Care Indicators for Data Collection
| Preconception Care Indicators | Definition for Preconception Visits (Yes/No Response) | Definition for Prenatal Intake Visit (Yes/No Response)12,28 |
|---|---|---|
| Pregnancy intention | Contraception counseling | Planned pregnancy |
| Access to care | Any primary care visit w/in 2 years | Prenatal intake visit <12 weeks gestational age (first trimester) |
| Preconception multivitamin with folic acid use | Education on use before conception | Use of a daily multivitamin with folic acid for at least 3 months before conception |
| Tobacco avoidance | Counseling on avoidance | Tobacco avoidance |
| Absence of uncontrolled depression | Depression screening negative (Negative PHQ-2 or PHQ-9 <10) | Depression screening negative (Negative PHQ-2 or PHQ-9 <10) |
| Healthy weight | BMI >18 and <30 | BMI >18 and <30 |
| Absence of STIs* | STI screening low risk** | STI screening negative |
| Optimal glycemic (if have pre-existing diabetes diagnosis) | Counseling on goal A1c <6.5% | A1c <6.5% |
| Teratogenic medication avoidance | Counseling on pregnancy risk with teratogenic drugs in pregnancy (previously, category X with mention of teratogenicity as the reason for being pregnancy category X) | No use of teratogenic drugs in pregnancy |
| Controlled chronic HTN | BP value ≤120/80 | BP value ≤120/80 |
| Harmful substance use avoidance | Counseling on avoidance of harmful substances (eg, marijuana, alcohol) | Avoidance of harmful substances (eg, marijuana, alcohol) |
↵* STI screening included testing for gonorrhea, chlamydia, HIV, hepatitis B and syphilis.
↵** STI low risk included a no response to all these patient-related questions: 1) Sexually active and >25 years old, 2) a new sex partner, 3) more than 1 sex partner, 4) a sex partner who has concurrent partners, 5) a sex partner who has an STI, 6) inconsistent condom use among persons who are not in mutually monogamous relationships, 7) personal history of STIs, 8) exchanging sex for money or drugs, 9) patient asks for STI screening, or simply agrees if offered by clinician.
Abbreviations: W/in, Within; PHQ-2, 2-item Patient Health Questionnaire; PHQ-9, 9-item Patient Health Questionnaire; BMI, body mass index; STI, sexually transmitted infection; HTN, hypertension; BP, blood pressure.