Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys

• Published in: Maternal and child health journal 2016-06, Vol.20 (6), p.1170-1177
• Main Authors: Batra, Priya, Higgins, Chandra, Chao, Shin M.
• Format: Article
• Language: English
• Subjects: Analysis; Babies; Behavior; Birth defects; Birth weight; Chronic illnesses; Counseling; Diabetes; Ethnic Groups - statistics & numerical data; Family planning; Female; Gynecology; Health aspects; Health Behavior; Health care; Health Surveys; Humans; Hypertension; Infant, Low Birth Weight; Infants; Intervention; Los Angeles - epidemiology; Maternal and Child Health; Medical care; Medicine; Medicine & Public Health; Obstetrics; Pediatrics; Polls & surveys; Population Economics; Population Surveillance - methods; Preconception Care - statistics & numerical data; Preconception Care - utilization; Pregnancy; Pregnancy Complications - epidemiology; Premature birth; Premature Birth - epidemiology; Premature infants; Prenatal Care - statistics & numerical data; Prenatal Care - utilization; Preventive medicine; Public Health; Regression Analysis; Risk Factors; Socioeconomic Factors; Sociology; Stillbirth; Surveys and Questionnaires; Womens health
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-015-1904-x

Objectives This study aimed to understand the impact of a previous adverse infant outcome (AIO) on use of preconception care prior to a subsequent pregnancy. Methods Responses from the 2010 and 2012 Los Angeles Mommy and Baby Surveys were analyzed. Weighted multivariate logistic regression was employed to identify significant associations between having had a previous AIO (preterm delivery, low birth weight infant, stillbirth, or major birth defect) and receipt of preconception care prior to the most recent pregnancy. Select patient-level covariates were included: chronic disease, age, education level, race/ethnicity, country of birth, insurance status prior to pregnancy and pregnancy intent. Adjustment for missing responses was performed using multiple chained imputation. Results After controlling for covariates, having had a previous AIO was associated with an increased odds of having utilized preconception care in the most recent pregnancy (OR 1.237, p  = 0.040). Per the final regression model, a woman reporting a previous AIO and an intended subsequent pregnancy had a 42.4 % likelihood of having used preconception care. Of these women, only 28.8 % reported doing so because of concern regarding a previous birth complication. Discussion Women reporting a previous AIO were more likely to have used preconception care in a subsequent pregnancy. The prevalence of preconception care utilization remained low overall. Pregnancy intent emerged as a strong secondary predictor; any concerted strategy to improve access to preconception care must include initiatives to help ensure that pregnancies are planned.