Interconception Health Services for Women at High Risk for Adverse Pregnancy Outcomes: A Descriptive Study

Abstract

Aims: To describe and present results of preconception care services aimed at underserved women who have experienced an adverse birth outcome. Study Design: Retrospective descriptive study. Place and Duration of Study: Sample: Maricopa Integrated Health System’s Internatal Clinic, a public safety-net hospital in Phoenix, Arizona USA, between March 2008 and October 2011. Methodology: 102 women who have experienced a prior preterm birth or stillbirth currently enrolled in an “Internatal Clinic” where interconception and prenatal care is provided. The interventions included education by clinicians and trained support staff, support groups, a walking program to address physical activity, contraception, folic acid intake, dental care, overweight/obesity, mental health and substance use issues prior to a future pregnancy. Chart reviews were performed and a preconception health survey addressing knowledge (pre/post) and patient satisfaction were analyzed using descriptive and univariate statistics. Results: Of current enrollees (N=102), 79% have been in the program for 12 to 18 months. 100% of those with mental health needs have had them addressed, 93% of those not desiring pregnancy are using contraception, 75% are consuming a folate supplement, 53% are engaging in regular exercise and 37% had oral health needs addressed despite no insurance coverage. Of the 102 patients, only 21% had a normal body mass index (18.5 to 24.9 kg/m2). Improvements in patient knowledge and attitudes were documented. Conclusion: Women in our program had improved preconception knowledge, attitudes and behaviors.