MMWR Morb Mortal Wkly Rep. 2012 Jul 27;61(29):550-5.
The first few weeks after conception are the most critical for fetal development; because most women are not aware that they are pregnant until after this critical period, health-care interventions should begin before conception. Promoting preconception health is an essential component of any broad strategy to prevent adverse pregnancy outcomes. Women who are planning pregnancy or could become pregnant should have a preconception health evaluation and adopt appropriate health behaviors. The Pregnancy Risk Assessment Monitoring System (PRAMS) tracks maternal behaviors, experiences, and health conditions, including preconception health. PRAMS is a state-specific, population-based surveillance system. The Texas Department of State Health Services analyzed PRAMS responses regarding preconception health of Texas women who delivered a live-born infant during 2002-2010. Among women who responded, 48% had no health-care insurance coverage before pregnancy and 46% reported an unintended pregnancy. In addition, 45% of the women reported consuming alcohol during the 3 months before pregnancy, and 18% reported binge drinking. Differences in demographic and socioeconomic variables were observed for the majority of preconception health indicators. Compared with non-Hispanic white women, non-Hispanic black and Hispanic women reported a 20% higher prevalence of not consuming a daily multivitamin and of being physically inactive, and approximately twice the prevalence of prepregnancy diabetes. Women without health-care coverage (public or private) before pregnancy generally were more likely to report unfavorable behavioral characteristics and health conditions compared with women with health-care coverage, regardless of whether the pregnancy was planned or not. Targeted public health interventions addressing the observed disparities in the preconception health and health care of women in Texas are needed.
受孕后的最初几周是胎儿发育最为关键的时期；由于大多数女性直到这一关键时期之后才意识到自己已经怀孕，因此医疗干预应在受孕之前开始。促进孕前健康是预防不良妊娠结局的任何广泛策略的重要组成部分。计划怀孕或可能怀孕的妇女应进行孕前健康评估并采取适当的健康行为。妊娠风险评估监测系统（PRAMS）跟踪产妇的行为、经历和健康状况，包括孕前健康。PRAMS 是一个州特异性、基于人群的监测系统。德克萨斯州卫生服务部分析了 PRAMS 关于在 2002 年至 2010 年期间分娩活产婴儿的德克萨斯州妇女的孕前健康的回复。在做出回复的妇女中，48%在怀孕前没有医疗保险，46%报告意外怀孕。此外，45%的妇女报告在怀孕前 3 个月内饮酒，18%报告酗酒。大多数孕前健康指标的人口统计学和社会经济变量存在差异。与非西班牙裔白人妇女相比，非西班牙裔黑人妇女和西班牙裔妇女报告不吃每日多种维生素和身体不活动的比例高 20%，孕前糖尿病的患病率约为两倍。与有医疗保险（公共或私人）的孕妇相比，怀孕前没有医疗保险的妇女通常更有可能报告不良行为特征和健康状况，而不论怀孕是否计划。需要针对德克萨斯州妇女孕前健康和医疗保健方面存在的差异开展有针对性的公共卫生干预。
