Purpose: To evaluate the effects of preconception care (PCC) consultations by change in lifestyle behaviors. Setting and Intervention: Women in deprived neighborhoods of 14 Dutch municipalities were encouraged to visit a general practitioner or midwife for PCC. Sample: The study included women aged 18 to 41 years who had a PCC consultation. Design: In this community-based prospective cohort study, we assessed initiation of folic acid supplementation, cessation of smoking, alcohol consumption, and illicit drug use. Measures: Self-reported and biomarker data on behavioral changes were obtained at baseline and 3 months later. Analysis: The changes in prevalence were assessed with the McNemar test. Results: Of the 259 included participants, paired analyses were available in 177 participants for self-reported outcomes and in 82 for biomarker outcomes. Baseline self-reported prevalence of no folic acid use was 36%, smoking 12%, weekly alcohol use 22%, and binge drinking 17%. Significant changes in prevalence toward better lifestyle during follow-up were seen for folic acid use (both self-reported, P < .001; and biomarker-confirmed, P = .008) and for self-reported binge drinking ( P = .007). Conclusion: Our study suggests that PCC contributes to initiation of folic acid supplementation and cessation of binge drinking in women who intend to become pregnant. Although based on a small sample, the study adds to the limited body of evidence regarding the benefits of PCC in improving periconception health.
Periconceptional folic acid supplementation and the risk of preterm births in China: a large prospective cohort study
