Prevalence of Periconception Risk Factors for Adverse Pregnancy Outcomes in a Cohort of Urban Indian Women: Implications for Preconception Health Education

Objective: This study aimed at determining the prevalence of selected periconception (pre- and early-post conception) risk factors for adverse pregnancy outcomes among urban Indian women, in order to identify the targets of a preconception education programme. Methods: Data on selected risk factors for adverse pregnancy outcomes was collected through face to face interview of 2107 pregnant women. Odds ratios (OR) were computed in order to identify the characteristics of women with higher numbers of risk factors. Results: The most prevalent risk factors were nutritional (lack of preconception folic acid supplement use 99.7%, anaemia 61% and malnutrition 41%), followed by social factors (low education levels 62%, low socioeconomic status 68%). There was high prevalence of chemical exposures in the household environment (household cleaners 76%, use of indoor insect repellents 64%). Women from families below the poverty line (OR 1.3, 95% CI 1.0-1.6) and with low education levels (OR 1.4, 95% CI 1.1-1.6) were more likely to report five or more risk factors. Conclusions: The high prevalence of risk factors for adverse pregnancy outcomes identifies the need for health promotion messages targeted at women in the preconception period with emphasis on pre pregnancy nutrition, and on limiting risk exposures within the household environment. The study identified a need to specially focus on poorly educated women from families below the poverty line.