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Published in: Italian Journal of Pediatrics 1/2014

Open Access 01-12-2014 | Research

Prevalence of maternal preconception risk factors: an Italian multicenter survey

Authors: Pierpaolo Mastroiacovo, Roy Miodini Nilsen, Emanuele Leoncini, Paolo Gastaldi, Valentina Allegri, Arianna Boiani, Francesca Faravelli, Federica Ferrazzoli, Andrea Guala, Valeria Madrigali, Gioacchino Scarano

Published in: Italian Journal of Pediatrics | Issue 1/2014

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Abstract

Objectives

Adequate preconception maternal health care is essential to reduce the risk of unwanted pregnancy outcomes and complications. Still, many women are exposed to a number of unhealthy risk factors both before and early in pregnancy. This study aimed to estimate the prevalence of a number of important preconception risk factors using data from a recent multicenter study in Italy.

Methods

The study was based on cross-sectional data from seven maternity clinics located in six different regions in Italy during the period January – June, 2012. Data on maternal preconception risk factors and characteristics were collected from 1,892 women who delivered healthy children and 320 women who were pregnant in the first trimester.

Results

About 97% of the women (n = 2,212) were exposed to one or more preconception risk factors. The overall prevalence of the most essential maternal risk factors was as follows: 41% had a age ≥35 years, 36% mistimed or did not intend their pregnancy, 58% did not request a preconception health visit to their doctor, 76% did not use folic acid supplements before pregnancy, 26% smoked at the last menstrual period, 19% had a body mass index ≥25 kg/m2 before pregnancy, and 10% suffered from pregestational chronic diseases. The prevalence of certain variables varied between the maternity clinics.

Conclusions

Many Italian women are exposed to a number of preconception risk factors that have been associated with adverse pregnancy complications and outcomes. More effective intervention programs to improve preconception health in Italian women are strongly needed.
Appendix
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Literature
1.
go back to reference Sadler TW: Langman’s Medical Embryology.: Wolters Kluwer/Lippincott Williams & Wilkins. 2012 Sadler TW: Langman’s Medical Embryology.: Wolters Kluwer/Lippincott Williams & Wilkins. 2012
2.
go back to reference Huhta J, Linask KK: Environmental origins of congenital heart disease: the heart-placenta connection. Semin Fetal Neonatal Med. 2013, 18 (5): 245-250. 10.1016/j.siny.2013.05.003. Epub 2013/06/12CrossRefPubMed Huhta J, Linask KK: Environmental origins of congenital heart disease: the heart-placenta connection. Semin Fetal Neonatal Med. 2013, 18 (5): 245-250. 10.1016/j.siny.2013.05.003. Epub 2013/06/12CrossRefPubMed
3.
go back to reference Johnson K, Posner SF, Biermann J, Cordero JF, Atrash HK, Parker CS, Boulet S, Curtis MG: Recommendations to improve preconception health and health care--United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recommend Rep: Morb Mortal Wkly Rep Recommend Rep/Cent Dis Contr. 2006, 55 (RR-6): 1-23. Epub 2006/04/18 Johnson K, Posner SF, Biermann J, Cordero JF, Atrash HK, Parker CS, Boulet S, Curtis MG: Recommendations to improve preconception health and health care--United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recommend Rep: Morb Mortal Wkly Rep Recommend Rep/Cent Dis Contr. 2006, 55 (RR-6): 1-23. Epub 2006/04/18
4.
go back to reference D'Angelo D, Williams L, Morrow B, Cox S, Harris N, Harrison L, Posner SF, Richardson Hood J, Zapata L: Preconception and interconception health status of women who recently gave birth to a live-born infant–Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. Morb Mortal Wkly Rep Surveill Summ. 2007, 56 (10): 1-35. Epub 2007/12/14 D'Angelo D, Williams L, Morrow B, Cox S, Harris N, Harrison L, Posner SF, Richardson Hood J, Zapata L: Preconception and interconception health status of women who recently gave birth to a live-born infant–Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. Morb Mortal Wkly Rep Surveill Summ. 2007, 56 (10): 1-35. Epub 2007/12/14
5.
go back to reference De Santis M, Quattrocchi T, Mappa I, Spagnuolo T, Licameli A, Chiaradia G, De Luca C: Folic acid use in planned pregnancy: an Italian survey. Matern Child Health J. 2013, 17 (4): 661-666. 10.1007/s10995-012-1047-2. Epub 2012/06/15CrossRefPubMed De Santis M, Quattrocchi T, Mappa I, Spagnuolo T, Licameli A, Chiaradia G, De Luca C: Folic acid use in planned pregnancy: an Italian survey. Matern Child Health J. 2013, 17 (4): 661-666. 10.1007/s10995-012-1047-2. Epub 2012/06/15CrossRefPubMed
6.
go back to reference Lauria L, Lamberti A, Grandolfo M: Smoking behaviour before, during, and after pregnancy: the effect of breastfeeding. Sci World J. 2012, 2012: 154910-10.1100/2012/154910. Epub 2012/04/27CrossRef Lauria L, Lamberti A, Grandolfo M: Smoking behaviour before, during, and after pregnancy: the effect of breastfeeding. Sci World J. 2012, 2012: 154910-10.1100/2012/154910. Epub 2012/04/27CrossRef
7.
go back to reference Pepe F, Pepe P, Montaperto A, Rotolo N, Florio ML, Uccellatore F: Folate consumption in the preconception period of Sicilian pregnant women and their knowledge about the prevention of neural tube defect by folate supplementation. Minerva Ginecol. 1999, 51 (5): 177-181. Epub 1999/08/04. Assunzione di folati in epoca periconcezionale in gravide siciliane e loro conoscenza della prevenzione dei DTN tramite somministrazione di folatiPubMed Pepe F, Pepe P, Montaperto A, Rotolo N, Florio ML, Uccellatore F: Folate consumption in the preconception period of Sicilian pregnant women and their knowledge about the prevention of neural tube defect by folate supplementation. Minerva Ginecol. 1999, 51 (5): 177-181. Epub 1999/08/04. Assunzione di folati in epoca periconcezionale in gravide siciliane e loro conoscenza della prevenzione dei DTN tramite somministrazione di folatiPubMed
8.
go back to reference Ronfani L, Marchetti E, Bortolus R, D'Andrea N, Taccardi R, Annona C, Ghiotti P, Mastroiacovo P, Tamburlini G: [Periconceptional supplementation with folic acid for the primary prevention of congenital malformations]. Pediatr Med Chir. 2004, 26 (2): 105-111. Epub 2005/02/11PubMed Ronfani L, Marchetti E, Bortolus R, D'Andrea N, Taccardi R, Annona C, Ghiotti P, Mastroiacovo P, Tamburlini G: [Periconceptional supplementation with folic acid for the primary prevention of congenital malformations]. Pediatr Med Chir. 2004, 26 (2): 105-111. Epub 2005/02/11PubMed
9.
go back to reference The European Perinatal Health Report 2010. 2012 The European Perinatal Health Report 2010. 2012
10.
go back to reference Lauria L, Lamberti A, Buoncristiano M, Bonciani M, Andreozzi S: (a cura di di) Percorso nascita: promozione e valutazione della qualità di modelli operativi. Le indagini del 2008–2009 e del 2010–2011. Rapporti ISTISAN. 2012 Lauria L, Lamberti A, Buoncristiano M, Bonciani M, Andreozzi S: (a cura di di) Percorso nascita: promozione e valutazione della qualità di modelli operativi. Le indagini del 2008–2009 e del 2010–2011. Rapporti ISTISAN. 2012
11.
go back to reference Morin P, Payette H, Moos MK, St-Cyr-Tribble D, Niyonsenga T, De Wals P: Measuring the intensity of pregnancy planning effort. Paediatr Perinat Epidemiol. 2003, 17 (1): 97-105. 10.1046/j.1365-3016.2003.00461.x. Epub 2003/02/04CrossRefPubMed Morin P, Payette H, Moos MK, St-Cyr-Tribble D, Niyonsenga T, De Wals P: Measuring the intensity of pregnancy planning effort. Paediatr Perinat Epidemiol. 2003, 17 (1): 97-105. 10.1046/j.1365-3016.2003.00461.x. Epub 2003/02/04CrossRefPubMed
12.
go back to reference Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995, 854: 1-452. Epub 1995/01/01 Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995, 854: 1-452. Epub 1995/01/01
13.
go back to reference Khoshnood B, Bouvier-Colle MH, Leridon H, Blondel B: Impact of advanced maternal age on fecundity and women's and children's health. J Gynecol Obstet Biol Reprod. 2008, 37 (8): 733-747. 10.1016/j.jgyn.2008.08.007. Epub 2008/10/22. Impact de l'age maternel eleve sur la fertilite, la sante de la mere et la sante de l'enfantCrossRef Khoshnood B, Bouvier-Colle MH, Leridon H, Blondel B: Impact of advanced maternal age on fecundity and women's and children's health. J Gynecol Obstet Biol Reprod. 2008, 37 (8): 733-747. 10.1016/j.jgyn.2008.08.007. Epub 2008/10/22. Impact de l'age maternel eleve sur la fertilite, la sante de la mere et la sante de l'enfantCrossRef
14.
go back to reference Natalità e fecondità popolazione residente - Anno 2012. 2013 Natalità e fecondità popolazione residente - Anno 2012. 2013
15.
go back to reference Mohllajee AP, Curtis KM, Morrow B, Marchbanks PA: Pregnancy intention and its relationship to birth and maternal outcomes. Obstet Gynecol. 2007, 109 (3): 678-686. 10.1097/01.AOG.0000255666.78427.c5. Epub 2007/03/03CrossRefPubMed Mohllajee AP, Curtis KM, Morrow B, Marchbanks PA: Pregnancy intention and its relationship to birth and maternal outcomes. Obstet Gynecol. 2007, 109 (3): 678-686. 10.1097/01.AOG.0000255666.78427.c5. Epub 2007/03/03CrossRefPubMed
16.
go back to reference Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR. 1992, 41 (No. RR-14): 1-7. Epub 1992/09/11 Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR. 1992, 41 (No. RR-14): 1-7. Epub 1992/09/11
17.
go back to reference de Walle HE, de Jong-van Den Berg LT: Ten years after the Dutch public health campaign on folic acid: the continuing challenge. Eur J Clin Pharmacol. 2008, 64 (5): 539-543. 10.1007/s00228-007-0446-6. Epub 2008/01/24PubMedCentralCrossRefPubMed de Walle HE, de Jong-van Den Berg LT: Ten years after the Dutch public health campaign on folic acid: the continuing challenge. Eur J Clin Pharmacol. 2008, 64 (5): 539-543. 10.1007/s00228-007-0446-6. Epub 2008/01/24PubMedCentralCrossRefPubMed
18.
go back to reference Molster C, Samanek A, Bower C, O'Leary P: A survey of folate knowledge and consumer behaviours in Western Australia prior to the introduction of mandatory food fortification. Aust N Z J Public Health. 2009, 33 (6): 577-582. 10.1111/j.1753-6405.2009.00456.x. Epub 2010/01/19CrossRefPubMed Molster C, Samanek A, Bower C, O'Leary P: A survey of folate knowledge and consumer behaviours in Western Australia prior to the introduction of mandatory food fortification. Aust N Z J Public Health. 2009, 33 (6): 577-582. 10.1111/j.1753-6405.2009.00456.x. Epub 2010/01/19CrossRefPubMed
19.
go back to reference Augood C, Duckitt K, Templeton AA: Smoking and female infertility: a systematic review and meta-analysis. Hum Reprod. 1998, 13 (6): 1532-1539. 10.1093/humrep/13.6.1532. Epub 1998/08/04CrossRefPubMed Augood C, Duckitt K, Templeton AA: Smoking and female infertility: a systematic review and meta-analysis. Hum Reprod. 1998, 13 (6): 1532-1539. 10.1093/humrep/13.6.1532. Epub 1998/08/04CrossRefPubMed
20.
go back to reference Hull MG, North K, Taylor H, Farrow A, Ford WC: Delayed conception and active and passive smoking. The Avon Longitudinal Study of Pregnancy and Childhood Study Team. Fertil Steril. 2000, 74 (4): 725-733. 10.1016/S0015-0282(00)01501-6. Epub 2000/10/06CrossRefPubMed Hull MG, North K, Taylor H, Farrow A, Ford WC: Delayed conception and active and passive smoking. The Avon Longitudinal Study of Pregnancy and Childhood Study Team. Fertil Steril. 2000, 74 (4): 725-733. 10.1016/S0015-0282(00)01501-6. Epub 2000/10/06CrossRefPubMed
21.
go back to reference Hackshaw A, Rodeck C, Boniface S: Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011, 17 (5): 589-604. 10.1093/humupd/dmr022. Epub 2011/07/13PubMedCentralCrossRefPubMed Hackshaw A, Rodeck C, Boniface S: Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls. Hum Reprod Update. 2011, 17 (5): 589-604. 10.1093/humupd/dmr022. Epub 2011/07/13PubMedCentralCrossRefPubMed
22.
23.
go back to reference Jokela M, Elovainio M, Kivimaki M: Lower fertility associated with obesity and underweight: the US National Longitudinal Survey of Youth. Am J Clin Nutr. 2008, 88 (4): 886-893. Epub 2008/10/10PubMed Jokela M, Elovainio M, Kivimaki M: Lower fertility associated with obesity and underweight: the US National Longitudinal Survey of Youth. Am J Clin Nutr. 2008, 88 (4): 886-893. Epub 2008/10/10PubMed
24.
go back to reference Metwally M, Ong KJ, Ledger WL, Li TC: Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril. 2008, 90 (3): 714-726. 10.1016/j.fertnstert.2007.07.1290. Epub 2007/12/11CrossRefPubMed Metwally M, Ong KJ, Ledger WL, Li TC: Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril. 2008, 90 (3): 714-726. 10.1016/j.fertnstert.2007.07.1290. Epub 2007/12/11CrossRefPubMed
25.
go back to reference Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, Curtis KM: Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007, 197 (3): 223-228. 10.1016/j.ajog.2007.03.027. Epub 2007/09/11CrossRefPubMed Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, Curtis KM: Maternal obesity and risk of stillbirth: a metaanalysis. Am J Obstet Gynecol. 2007, 197 (3): 223-228. 10.1016/j.ajog.2007.03.027. Epub 2007/09/11CrossRefPubMed
26.
go back to reference Stothard KJ, Tennant PW, Bell R, Rankin J: Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009, 301 (6): 636-650. 10.1001/jama.2009.113. Epub 2009/02/13CrossRefPubMed Stothard KJ, Tennant PW, Bell R, Rankin J: Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA. 2009, 301 (6): 636-650. 10.1001/jama.2009.113. Epub 2009/02/13CrossRefPubMed
28.
go back to reference Irgens LM: The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand. 2000, 79 (6): 435-439. 10.1080/j.1600-0412.2000.079006435.x. Epub 2000/06/17CrossRefPubMed Irgens LM: The Medical Birth Registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand. 2000, 79 (6): 435-439. 10.1080/j.1600-0412.2000.079006435.x. Epub 2000/06/17CrossRefPubMed
29.
go back to reference Knudsen LB, Olsen J: The Danish Medical Birth Registry. Dan Med Bull. 1998, 45 (3): 320-323. Epub 1998/07/24PubMed Knudsen LB, Olsen J: The Danish Medical Birth Registry. Dan Med Bull. 1998, 45 (3): 320-323. Epub 1998/07/24PubMed
30.
go back to reference Nilsen RM, Vollset SE, Rasmussen SA, Ueland PM, Daltveit AK: Folic acid and multivitamin supplement use and risk of placental abruption: a population-based registry study. Am J Epidemiol. 2008, 167 (7): 867-874. 10.1093/aje/kwm373. Epub 2008/01/12CrossRefPubMed Nilsen RM, Vollset SE, Rasmussen SA, Ueland PM, Daltveit AK: Folic acid and multivitamin supplement use and risk of placental abruption: a population-based registry study. Am J Epidemiol. 2008, 167 (7): 867-874. 10.1093/aje/kwm373. Epub 2008/01/12CrossRefPubMed
31.
go back to reference Tanvig M, Wehberg S, Vinter CA, Joergensen JS, Ovesen PG, Beck-Nielsen H, Jensen DM, Christesen HT: Pregestational body mass index is related to neonatal abdominal circumference at birth–a Danish population-based study. BJOG. 2013, 120 (3): 320-330. 10.1111/1471-0528.12062. Epub 2012/11/14CrossRefPubMed Tanvig M, Wehberg S, Vinter CA, Joergensen JS, Ovesen PG, Beck-Nielsen H, Jensen DM, Christesen HT: Pregestational body mass index is related to neonatal abdominal circumference at birth–a Danish population-based study. BJOG. 2013, 120 (3): 320-330. 10.1111/1471-0528.12062. Epub 2012/11/14CrossRefPubMed
32.
go back to reference van der Pal-de Bruin KM, le Cessie S, Elsinga J, de Jong-Potjer LC, van Haeringen A, Neven AK, Verloove-Vanhorick SP, Assendelft P: Pre-conception counselling in primary care: prevalence of risk factors among couples contemplating pregnancy. Paediatr Perinat Epidemiol. 2008, 22 (3): 280-287. 10.1111/j.1365-3016.2008.00930.x. Epub 2008/04/23CrossRefPubMed van der Pal-de Bruin KM, le Cessie S, Elsinga J, de Jong-Potjer LC, van Haeringen A, Neven AK, Verloove-Vanhorick SP, Assendelft P: Pre-conception counselling in primary care: prevalence of risk factors among couples contemplating pregnancy. Paediatr Perinat Epidemiol. 2008, 22 (3): 280-287. 10.1111/j.1365-3016.2008.00930.x. Epub 2008/04/23CrossRefPubMed
Metadata
Title
Prevalence of maternal preconception risk factors: an Italian multicenter survey
Authors
Pierpaolo Mastroiacovo
Roy Miodini Nilsen
Emanuele Leoncini
Paolo Gastaldi
Valentina Allegri
Arianna Boiani
Francesca Faravelli
Federica Ferrazzoli
Andrea Guala
Valeria Madrigali
Gioacchino Scarano
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2014
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-014-0091-5

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