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Cited by 156Maternal and Neonatal HealthcarePregnancy and Medication ImpactReproductive Health and Contraception

The Effect of Preconception Counselling on Lifestyle and Other Behaviour Before and During Pregnancy

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Elsinga, Joyce, de Jong-Potjer, Lieke C., van der Pal-de Bruin, Karin M., le Cessie, Saskia, Assendelft, Willem J.J., Buitendijk, Simone E.·2008·Women's Health Issues
DOI 10.1016/j.whi.2008.09.003
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Abstract

Background Recent studies suggest that the basis for adverse pregnancy outcomes is often established early in pregnancy, during organogenesis. It is therefore important to take preventive action as early as possible, preferably before pregnancy. Because most adverse pregnancy outcomes occur in women who are unaware of being at risk, we conducted a randomized controlled trial, "Parents to Be." With this study, we sought to assess the extent to which women who have participated in preconception counseling (PCC) increase their knowledge on pregnancy-related risk factors and preventive measures and change their behavior before and during pregnancy and to provide an overview of adverse pregnancy outcomes among such women. Methods Knowledge: Women aged 18-40 who attended PCC and women who received standard care were matched on previous pregnancy, time since last pregnancy, age, country of birth, and educational achievement. They were sent a questionnaire on knowledge about pregnancy-related risk factors and preventive measures. Behavior: Data on pregnancies and outcomes were collected. Two months after pregnancy, a questionnaire was sent regarding behavior before and during pregnancy. Results Knowledge of women who received PCC (81.5%; n=211) exceeded that of women who did not (76.9%; n=422). Levels of knowledge in women who were not yet pregnant after PCC were comparable to those in women who became pregnant after PCC, indicating that, even before pregnancy, PCC increased knowledge in women contemplating pregnancy. After PCC, significantly more women started using folic acid before pregnancy (adjusted odds ratio [OR], 4.93; 95% confidence interval [CI], 2.81-8.66) and reduced alcohol use during the first 3 months of pregnancy (adjusted OR, 1.79; 95% CI, 1.08-2.97). Among the group receiving standard care, about 20% of all pregnancies ended in an adverse outcome; in the group with PCC this was 16% (OR, 0.77; 95% CI, 0.48-1.22). Conclusion After PCC, women have more knowledge about essential items. Importantly, they gained this greater knowledge before pregnancy and more women changed their behavior to reduce adverse pregnancy outcomes.

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  • Lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception.

    “Evidence suggests that lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception [4–7].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [7]

  • The potential effect of healthy periconceptional lifestyle behaviours on reducing multiple adverse pregnancy outcomes together is yet understudied, and it has been studied only in small sample sizes.

    “The potential effect of healthy periconceptional lifestyle behaviours on reducing multiple adverse pregnancy outcomes together is yet understudied, and it has been studied only in small sample sizes [7, 21].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [7]

  • Several studies aimed to implement preconception care (PCC) programs and some successfully led to an improved level of knowledge regarding PCC and subsequent improved periconceptional lifestyle behaviours.

    “Several studies aimed to implement PCC programs and some successfully led to an improved level of knowledge regarding PCC and subsequent improved periconceptional lifestyle behaviours [7, 18–20].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [7]

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Authors
Elsinga, J., de Jong-Potjer, L. C., van der Pal-de Bruin, K. M., le Cessie, S., Assendelft, W. J. J., & Buitendijk, S. E.
Affiliations
  • Leiden University Medical Center (NL)
  • Netherlands Organisation for Applied Scientific Research (NL)
ORCID
Assendelft, Willem J.J.
Venue
Women's Health Issues
Publisher
Elsevier BV
Published
2008-11
Volume
18
Issue
6
Pages
S117-S125
ISSN
1049-3867 (ISSN-L)
DOI
10.1016/j.whi.2008.09.003
OpenAlex
W2128842511
Cited by
156
References
32
Citations by year
2026: 4 · 2025: 5 · 2024: 2 · 2023: 15 · 2022: 21 · 2021: 10 · 2020: 5 · 2019: 9 · 2018: 9 · 2017: 14 · 2016: 11 · 2015: 8 · 2014: 11 · 2013: 7 · 2012: 10
FWCI
9.67
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Women s Health Issues (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • TNO Repository (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • Repository hosted by TU Delft Library (TU Delft) (submittedVersion)
Funders
ZonMw
Topics
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords
preconception counseling, pregnancy risk factors, folic acid supplementation, alcohol use in pregnancy, adverse pregnancy outcomes, contraception
MeSH terms
Adult, Counseling, Female, Humans, Health Knowledge, Attitudes, Practice, Life Style, Maternal Behavior, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Prenatal Care, Surveys and Questionnaires, Self Care, Health Behavior, Odds Ratio, Preconception Care, Treatment Outcome, Young Adult

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