Change in Lifestyle Behaviors After Preconception Care: A Prospective Cohort Study

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.