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Child Health USA 2013 An illustrated collection of current and historical data, published annually.

Preconception Health

Narrative

Efforts to improve pregnancy outcomes and the health of mothers and infants should begin prior to conception, whether before a first or subsequent pregnancy.1 As many women are not aware of being pregnant at first, it is important to establish healthy behaviors and achieve optimal health well before pregnancy. Key indicators of preconception health include not smoking or abusing alcohol prior to pregnancy, taking a daily multi-vitamin, and maintaining a healthy weight.2

Frequent use of alcohol, especially early in pregnancy, can cause fetal alcohol syndrome and alcohol-related birth defects.3,4 Smoking also increases the risk of pregnancy complications, preterm birth, and low birth weight.5 In 2009–2010, about one in four recent mothers in a 30-state area reported binge drinking (consuming 4 or more drinks in a sitting) at least once within 3 months prior to pregnancy (26.6 percent) and 24.2 percent reported smoking during the same time period. Smoking prior to pregnancy varied by maternal education, ranging from 9.6 percent of mothers with 16 or more years of education to 34.3 percent of mothers with 12 years of education. Binge drinking was most common among mothers with 13-15 years of education (31.9 percent), and least common among those who had less than 12 years (16.3 percent). Binge drinking and smoking in the three months prior to pregnancy also tend to be more common among younger mothers. For example, among 20- to 24-year-old women, 31.1 percent reported binge drinking in the 3 months prior to pregnancy and 35.3 percent reported smoking, compared to 18.6 and 13.3 percent, respectively, among women aged 35 and older (data not shown in graph images or in data tables on this site).

Daily use of multi-vitamins containing folic acid can reduce the risk of neural tube defects in infants by two-thirds.6 In 2009-2010, only 30.1 percent of recent mothers reported daily multivitamin use in the month prior to pregnancy. With regard to maternal education, half (48.2 percent) of women with 16 or more years of education reported taking a daily multi-vitamin in the month prior to pregnancy compared to about 20 percent of women with 12 years or less.

Women should also attain a healthy weight prior to pregnancy to prevent complications, such as diabetes and hypertension, which may increase the risk of preterm delivery.7 About half of new mothers (50.1 percent) reported a healthy pre-pregnancy weight. This proportion varied by maternal age, with teenage mothers being the most likely to have had a normal pre-pregnancy weight (58.7 percent; data not shown in graph images or in data tables on this site). With respect to race and ethnicity, Non-Hispanic Asian mothers were most likely to have a healthy pre-pregnancy weight (66.2 percent, as compared to mothers of all other racial and ethnic groups (data not shown in graph images or in data tables on this site).

1 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.

2 U.S. Department of Health and Human Services. Healthy People 2020 Topics & Objectives: Maternal, Infant, and Child Health. Accessed: 07/19/13.

3 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.

4 PubMed Health. Diseases and Conditions: Fetal Alcohol Syndrome. Aug 2012. Retrieved from: Accessed: 07/19/13.

5 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.

6 Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities. Facts about Folic Acid. Accessed: 08/1/13.

7 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.

Graphs

This image is described in the Data section.

Selected Preconception Health Indicators graph

Data

Selected Preconception Health Indicators Among Recent Mothers, by Maternal Education, 2009-2010*
Years of Education Less Than 12 Years 12 Years 13-15 Years 16 Years or More Total
*Includes data from a total of 30 states and New York City; 25 states contributed both years. Mothers completed surveys between 2 and 9 months postpartum.
**Defined as drinking 4 or more alcohol drinks in one sitting at least once in the 3 months prior to pregnancy.
†Defined as a pre-pregnancy body mass index (ratio of weight to height) between 18.5 and 24.9.
Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2009-2010. Analysis conducted by the Centers for Disease Control and Prevention, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion.
Binge Drinking** 16.3 27.4 31.9 27.7 26.6
Smoking 28.6 34.3 27.1 9.6 24.2
Daily Multi-Vitamin Use 19.3 20.7 26.9 48.2 30.1
Normal Weight 48.3 44.9 45.7 59.7 50.1