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Open Access Research article

A cohort study of a tailored web intervention for preconception care

Eleonora Agricola1*, Elisabetta Pandolfi1, Michaela V Gonfiantini1, Francesco Gesualdo1, Mariateresa Romano2, Emanuela Carloni1, Pierpaolo Mastroiacovo3 and Alberto E Tozzi1

Author Affiliations

1 Bambino Gesù Children’s Hospital IRCCS, Epidemiology Unit, Piazza S. Onofrio 4, Rome 00165, Italy

2 Department of Onco-Ematology and Transplantation Medicine, Bambino Gesù Children’s Hospital IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy

3 Alessandra Lisi International Centre on Birth Defects and Prematurity, Via Carlo Mirabello 14, Rome 00192, Italy

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BMC Medical Informatics and Decision Making 2014, 14:33  doi:10.1186/1472-6947-14-33

Published: 15 April 2014



Preconception care may be an efficacious tool to reduce risk factors for adverse pregnancy outcomes that are associated with lifestyles and health status before pregnancy. We conducted a web-based cohort study in Italian women planning a pregnancy to assess whether a tailored web intervention may change knowledge and behaviours associated with risks for adverse pregnancy outcomes.


The study was entirely conducted on the web on a cohort of Italian women of childbearing age. Data collected at baseline on health status, lifestyles and knowledge of risk factors for adverse pregnancy outcomes were used for generating a tailored document including recommendations for folic acid supplementation, obesity and underweight, smoking, alcohol consumption, vaccinations, chronic and genetic diseases, exposure to medications. Prevalence of risk factors and knowledge was assessed 6 months after the intervention. Logistic regression models were used to explore the factors associated with risk factors after the intervention.


Of the 508 enrolled women, 282 (55.5%) completed the study after 6 months since the delivery of tailored recommendations. At baseline, 48% of the participants took folic acid supplementation (95% CI 43.2; 51.9) and 69% consumed alcohol (95% CI 64.7; 72.9). At the follow up 71% of the participants had a preconception visit with a physician. Moreover we observed a decrease of alcohol consumption (−46.5% 95% CI −53.28; −38.75) and of the proportion of women not taking folic acid supplementation (−23.4% 95% CI −31.0; 15.36). We observed an improvement in knowledge of the information about the preconception behaviours to prevent adverse pregnancy outcomes (20.9% 95% CI 14.6%; 27.1%). Having a preconception visit during follow up was significally associated to an increase in folic acid supplementation (OR 2.53 95% CI 1.40; 4.60).


Our results suggest that a tailored web intervention may improve general preconception health in women planning a pregnancy. A web preconception intervention may be integrated with classic preconception care by health professionals. Clinical trials should be conducted to confirm these findings.

Preconception care; Preconception health; Preconception counselling; Adverse pregnancy outcomes; Folic acid; Web intervention; Internet; Lifestyles