Development and validation of preconception care improvement scale (PCIS) in a resource-limited setting

Background Preconception care helps to close the gaps in a continuum of care. It is of paramount importance to reduce maternal and child adverse pregnancy outcomes, increase the utilization of services such as antenatal care, skilled delivery care, and post-natal care, and improve the lives of future generations. Therefore, a validated instrument is required. The purpose of this study was to develop and validate the preconception care improvement scale (PCIS) in a resource-limited setting. Methods A mixed-method study was carried out from 02, March to 10, April 2019 in Manna district, Oromia region, Ethiopia to test the reliability and validity of the scale. Items were generated from literatures review, in-depth interviews with different individuals, and focused group discussions with women of reproductive age groups. A pretested structured questionnaire was used and a survey was conducted among 623 pregnant women in the district. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 software and data were analyzed for internal consistency and validity using reliability analysis and factor analysis. Results The PCIS has 17 items loaded into six factors: Substance-related behaviors, screening for common non-communicable and infectious diseases, micronutrient supplementation and vaccination, seeking advice, decision and readiness for conception, and screening for sexually transmitted diseases. Factor analysis accounted for 67.51% of the observed variance. The internal consistency (Cronbach’s alpha) of the scale was 0.776. Diversified participants of the qualitative study and experts’ discussions assured the face and content validity of the scale. Factor loading indicated the convergent validity of the scale. Three of the PCIS subscale scores had a positive and significant association with the practice of preconception care and antenatal care visits, which confirmed the predictive validity of the scale. Conclusion The PCIS exhibited good reliability, face validity, content validity, convergent validity, and predictive validity. Thus, the scale is valid and helps to improve preconception care, especially in resource-limited settings.

Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia

Introduction There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman’s may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town. Methods A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05. Result This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization. Conclusions The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women’s/couples knowledge & strengthening counseling services is pivotal.

Management of patients with herpes-associated recurrent vulvovaginal candidiasis

Objective. To develop a diagnostic algorithm, a rational method of treatment, and principles of preconception care in women with herpes-associated recurrent vulvovaginal candidiasis (RVVC).Materials and methods. We examined 68 patients with herpes-associated RVVC and 20 gynecologically healthy women.Results. It has been found that in RVVC it is necessary to study vaginal swab culture with the determination of the microorganism and its biofilm-forming ability in combination with viral DNA detection by the polymerase chain reaction (PCR) in vaginal secretion, determination of the IgG titer to the herpes simplex virus (HSV), the avidity index to HSV I and II. In the presence of laboratory-confirmed RVVC and HSV infection, it is necessary to assume the presence of an atypical course of HSV infection followed by complex antiviral and antimycotic therapy.Conclusion. The use of the developed algorithm of diagnostic and treatment interventions as preconception care makes it possible to address symptoms, reduce relapse rates and extend a non-relapse interval, prepare women with the mixed-infection for favorable pregnancy outcomes.

Family Planning Programs – An Opportunity to Integrate Preconception Health Services into Primary Health Care

A life-course approach to enhancing maternal and child health by improving parental health prior to conception is gaining international interest. Healthcare providers and researchers are seeking effective ways to increase women’s and men’s access to preconception care, especially through primary care. At the same time, preconception health includes conversations about pregnancy planning (or avoidance), which is a part of FP services. Unfortunately, “family planning” has the same meaning as “contraception” for many people at the moment, which is too simplistic because there are multiple aspects of preconception health and well-being. Expanding the understanding of preconception health as inclusive of FP and primary care has the potential to increase access to this important care while respecting sexual and reproductive rights, according to a couple’s reproductive plans. Respecting the sexual and reproductive rights of the population requires that FP programs be focused not only on contraception but, equally, on preconception care.

Association between halitosis and female fecundability in China: a prospective cohort study

Background Periodontal diseases and poor oral hygiene are potentially associated with decreased female fecundability. Fecundability refers to the probability of conception during a given period measured in months or menstrual cycles. This study aims to examine whether halitosis is associated with female fecundability in a large sample of Chinese women who planned to be pregnant. Methods In 2012, a total of 6319 couples came for preconception care in eight districts in Shanghai, China and were followed by telephone contact. Three thousand nine hundred fifteen women who continued trying to be pregnant for up to 24 months remained for final statistical analyses. Halitosis was self-reported at the preconception care visit. Time to pregnancy (TTP) was reported in months and was censored at 24 months. Fecundability ratio (FR) was defined as the ratio of probability of conception among those with and without halitosis. FR and 95% confidence interval (CI) were estimated using the discrete-time Cox model. Results 80.1 and 86.1% of women had self-reported clinically confirmed pregnancy within 12 and 24 months, respectively. Halitosis was reported in 8.7% of the women. After controlling for potential confounders, halitosis was associated with a reduced probability of spontaneous conception (for an observation period of 12 months: adjusted FR 0.82, 95% CI 0.72–0.94; for an observation period of 24 months: adjusted FR 0.84, 95% CI 0.74–0.96). Conclusions Halitosis is associated with reduced fecundability in Chinese women.

“PerConcept” study: provider opinions about integrating preconception care into family planning services

The importance of preconception care for the mother and child health has long been demonstrated, but the practical realization of this prophylactic activity remains insignificant. Th e article presents the “PerConcept” study results – a survey on “Family Planning” concept perceptions among physicians, whose activity is related to reproductive health. Th e study was conducted based on a unified questionnaire in three cities from three countries: Chisinau (Republic of Moldova), Irkutsk (the Russian Federation) and Ciudad de Mexico (Mexico). Th e survey involved 1.012 family physicians, obstetricians gynecologists, urologists, andrologists, but also doctors of other specialties. A number of 991 questionnaires were validated and analyzed. About 79.5% of all respondents (788) reported that the term of “family” is associated with the birth of children. About 96.0% of respondents (951) believed that pregnancy should be planned by the couple/woman. From a professional perspective, 862 physicians (94.5%), consider that the concept of family planning should also really include a component of preconception care, simultaneous with contraception. Th e majority of participants – 91.1%, (831) had the opinion that strategies and programs in the field of family planning should be revised, in order to include preconception health services. Although the “PerConcept” study had some limitations, the authors consider that the results are interesting because doctors from 3 regions of the world: Europe, Asia, and North America had a similar opinion about the need to expand the family planning concept, which should really include the preconception care, with an equal approach as another component – contraception.