Izaddoost Niloufar, Amiri-Farahani Leila, Sajjadian Fatemeh, Pezaro Sally
Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
The Research Centre for Healthcare and Communities, Coventry University, Coventry, UK.
BMC Pregnancy Childbirth. 2024 Dec 19;24(1):824. doi: 10.1186/s12884-024-07041-6.
Preconceptional care aims to improve health and is influenced by various factors including health literacy. Considering the importance and necessity of high quality preconceptional care, this study aimed to determine the predictors of receiving care and folic acid supplementation prior to pregnancy.
This cross-sectional study included 693 participants with pregnancies of less than 14 weeks gestation referred to health centers and gynecologists in Shiraz city, Iran. Multi-stage sampling occurred from May 2021 to February 2022 in 18 comprehensive urban health centers and 20 gynecology offices via the proportional allocation method. Data was collected using a questionnaire consisting of 3 parts: 1) individual and fertility characteristics, 2) information related to the components of preconceptional care and 3) health literacy. This was completed by individual participants who self-reported their responses.
Examining the frequency of the variables related to individual characteristics revealed that the mean age of participants in the study was 30.32 with a standard deviation of 5.29 years and more than half (59.3%) had a university level education. The receipt of pre-conceptual care was found to have a statistically significant relationship with the following: level of education, employment status, length of marriage, number of pregnancies, week of pregnancy and whether it was planned or not, along with health literacy (P < 0.05). Folic acid supplementation was found to have a statistically significant relationship with the following: level of education, financial status of the family, length of marriage, number of pregnancies and current pregnancy status (P < 0.05). In examining the predictive effect of individual variables and health literacy in the logistic regression model with the outcome of receiving preconceptional care and folic acid supplementation, length of marriage, health literacy, occupational status, and pregnancy planning status variables remained in the model following analysis.
Several factors had a statistically significant relationship with receiving pre-conceptual care and folic acid supplementation. In order to improve pre-conceptual care and increase folic acid supplementation, special attention must be paid to improving health literacy, increasing levels of education and reducing unplanned pregnancies.
孕前保健旨在改善健康状况，且受到包括健康素养在内的多种因素影响。鉴于高质量孕前保健的重要性和必要性，本研究旨在确定孕前接受保健服务及补充叶酸的预测因素。
本横断面研究纳入了693名妊娠小于14周的参与者，他们前往伊朗设拉子市的健康中心和妇科医生处就诊。2021年5月至2022年2月期间，通过比例分配法在18个城市综合健康中心和20个妇科诊所进行了多阶段抽样。数据通过一份由三部分组成的问卷收集：1）个人及生育特征；2）与孕前保健各组成部分相关的信息；3）健康素养。由参与者自行报告完成问卷作答。
对与个人特征相关变量的频率进行检查发现，研究中参与者的平均年龄为30.32岁，标准差为5.29岁，超过一半（59.3%）拥有大学学历。发现接受孕前保健与以下因素存在统计学显著关联：教育水平、就业状况、婚姻时长、妊娠次数、孕周以及是否为计划妊娠，还有健康素养（P < 0.05）。发现补充叶酸与以下因素存在统计学显著关联：教育水平、家庭经济状况、婚姻时长、妊娠次数以及当前妊娠状况（P < 0.05）。在逻辑回归模型中检验个人变量和健康素养对接受孕前保健及补充叶酸结果的预测作用时，分析后婚姻时长、健康素养、职业状况和妊娠计划状况变量仍保留在模型中。
若干因素与接受孕前保健及补充叶酸存在统计学显著关联。为改善孕前保健并增加叶酸补充，必须特别关注提高健康素养、提升教育水平以及减少意外妊娠。
