Associations Between Preconception Counseling and Maternal Behaviors Before and During Pregnancy

Preconception counseling (PCC) is a vital component of preconception care. Through counseling, providers educate and recommend
strategies to improve health and birth outcomes for women of reproductive age. The objective of our analysis was to assess
the associations between receipt of PCC and positive maternal behaviors before and during pregnancy. We analyzed 2004–2008
Pregnancy Risk Assessment Monitoring System data from Maine, New Jersey, Utah, and Vermont. Multivariable logistic regression
was used to investigate the associations between receipt of PCC and prepregnancy daily multivitamin consumption, first-trimester
entry into prenatal care, and cessation of smoking and drinking before pregnancy among women who smoked/drank in the 2 years
preceding the survey, adjusting for a wide range of maternal characteristics. Overall, 32% of women reported receipt of PCC,
with particularly low rates reported among women with an unintended pregnancy (14%) and no health insurance prior to pregnancy
(14%). Receipt of PCC was associated with daily prepregnancy multivitamin consumption (adjusted odds ratio [AOR] = 4.4; 95%
confidence interval [CI] = 4.0, 4.7), first-trimester entry into prenatal care for women with an intended pregnancy (AOR = 2.1;
95% CI = 1.8, 2.4), and drinking cessation before pregnancy among women who drank in the 2 years preceding the survey (AOR = 1.3;
95% CI = 1.2, 1.5). PCC was associated with positive maternal behaviors that increase the likelihood of a healthy woman, pregnancy,
and infant. Unfortunately, less than one-third of women with a recent live birth reported receiving PCC. These data provide
population-based evidence suggesting the value of PCC in the promotion of healthy maternal behaviors for women with intended
or unintended pregnancies.