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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

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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