Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
J Clin Nurs. 2023 Aug;32(15-16):4843-4851. doi: 10.1111/jocn.16584. Epub 2022 Dec 2.
Optimising preconception health-that is the health of women and men prior to a potential pregnancy-is increasingly recognised as fundamental to improving maternal and infant health outcomes. To date, limited research has been conducted examining preconception knowledge and studies focusing on preconception health behaviours have targeted certain behaviours, while overlooking others, with limited attention given to the interconception period and differences between multiparous and primiparous/nulliparous women.
To determine predictors of preconception health knowledge among Canadian women and to examine whether parity modified the effect of predictors on preconception knowledge.
A cross-sectional study reported according to STROBE was undertaken from May to June 2019 in Canada with 928 women. An online questionnaire was used including the Preconception Health Knowledge Questionnaire, demographic characteristics, current health status, previous pregnancy outcomes and use of preconception care services. Ordinary least squares regression was used to model knowledge scores. Predictors were entered using theoretically driven hierarchical entry.
Mean age of women was 34 years and one in five were immigrants. In the final model, household income (b = .17, SE = .07; p = .009), being born outside Canada (b = -.75, SE = .25; p = .003), miscarriage/stillbirth history (b = .47, SE = .21; p = .027) and previous use of preconception care (b = .97, SE = .20, p ⟩ .001) were predictive of preconception health knowledge. Effect modification by parity was not statistically significant in the final model (f = 1.22, p = .19).
Women at higher risk of poor preconception knowledge, and who therefore stand to gain from preconception knowledge interventions may include those who (1) are socially and economically disadvantaged; (2) have not engaged in preconception care previously and (3) were not born in Canada. Ensuring national promotion of and access to preconception care is an important strategy to prevent adverse pregnancy outcomes and optimise maternal and infant health.
This study highlights the need for national promotion of and access to preconception health care for all pregnancy-planning families in order to improve perinatal outcomes.
When evaluating preconception health efforts, preconception health knowledge must be considered within the context of social determinants of health and individuals' abilities to act on their knowledge.
越来越多的人认识到，优化孕前健康——即女性和男性在潜在怀孕前的健康——对于改善母婴健康结果至关重要。迄今为止，针对孕前知识的研究有限，而专注于孕前健康行为的研究则针对某些行为，而忽略了其他行为，对受孕间隔和多胎、初产和无胎次妇女之间的差异关注甚少。
确定加拿大女性孕前健康知识的预测因素，并研究生育状况是否改变了预测因素对孕前知识的影响。
2019 年 5 月至 6 月，按照 STROBE 报告标准，在加拿大进行了一项横断面研究，共纳入 928 名女性。采用在线问卷，包括孕前健康知识问卷、人口统计学特征、当前健康状况、既往妊娠结局和孕前保健服务使用情况。采用普通最小二乘法回归对知识评分进行建模。使用理论驱动的分层进入法输入预测因素。
女性的平均年龄为 34 岁，五分之一为移民。在最终模型中，家庭收入（b=0.17，SE=0.07；p=0.009）、在加拿大境外出生（b=-0.75，SE=0.25；p=0.003）、流产/死产史（b=0.47，SE=0.21；p=0.027）和既往使用孕前保健（b=0.97，SE=0.20，p＜0.001）是孕前健康知识的预测因素。最终模型中生育状况的修饰作用不具有统计学意义（f=1.22，p=0.19）。
那些（1）社会经济地位较低的；（2）以前没有参与过孕前保健的；（3）不是在加拿大出生的）风险较高的女性，可能需要国家推广和获得孕前保健，以预防不良妊娠结局，优化母婴健康。
本研究强调需要在全国范围内推广和提供孕前保健，以改善围产期结局，为所有计划怀孕的家庭服务。
在评估孕前健康工作时，必须在健康的社会决定因素和个人实施知识的能力的背景下考虑孕前健康知识。
