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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 It is important to establish health and healthy behaviors well before pregnancy as most women do not become aware of their pregnancy until several weeks or more after conception. Key indicators of preconception health include not smoking or drinking prior to pregnancy, taking a daily multi-vitamin, and achieving a healthy weight prior to pregnancy.2

Frequent drinking, especially early in pregnancy, can cause fetal alcohol syndrome and alcohol-related birth defects.1,3 Smoking also increases the risk of pregnancy complications, preterm birth, and low birth weight.1 In 2006–2008, nearly one in five recent mothers in a 29-state area reported binge drinking (consumed 5 or more drinks in a sitting ) at least once within 3 months prior to pregnancy (18.8 percent) and 22.3 percent reported smoking. Binge drinking and smoking in the three months prior to pregnancy were highest among non-Hispanic American Indian/Alaska Native women (27.4 and 44.0 percent, respectively). Non-Hispanic White, non-Hispanic Native Hawaiian, and non-Hispanic women of multiple races also had elevated rates of preconception substance use, while non-Hispanic Asian women had the lowest reported rates.

Daily use of multi-vitamins containing folic acid can reduce the risk of neural tube defects in infants by two-thirds.1 In 2006–2008, only 29.7 percent of recent mothers reported daily multi-vitamin use in the month prior to pregnancy. Daily preconception multi-vitamin use was highest among non-Hispanic Asian mothers (38.2 percent), followed by non-Hispanic White mothers (33.3 percent); only about one in five mothers of other racial and ethnic groups consumed daily multi-vitamins prior to pregnancy.

Women should also attain a healthy weight prior to pregnancy. Only about half of new mothers (51.1 percent) reported a healthy or normal pre-pregnancy weight for their height. Non-Hispanic Asian mothers were most likely to have attained a healthy pre-pregnancy weight (58.9 percent), while non-Hispanic Black mothers were least likely (42.4 percent). About one-third of non-Hispanic Black and non-Hispanic American Indian/Alaska Native mothers were obese prior to pregnancy.

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).
2 U.S. Department of Health and Human Services. Healthy People 2020 Topics & Objectives: Maternal, Infant, and Child Health. Accessed 04/15/11.
3 National Center for Biotechnology Information. PubMed Health. Diseases and Conditions: Fetal Alcohol Syndrome. September 2009. Accessed 04/15/11.

Graph

Data

Selected Preconception Health Indicators Among Recent Mothers, by Race/Ethnicity, 2006–2008*
Race/Ethnicity Percent of Mothers
Normal Weight** Daily Multivitamin Use Smoking Binge Drinking†
*Includes data from a total of 29 states and New York City; 20 states contributed all 3 years; mothers completed surveys between 2 and 9 months postpartum.
**Defined as a pre-pregnancy body mass index (ratio of weight to height) between 18.5 and 24.9.
†Defined as drinking 5 or more alcohol drinks in one sitting at least once in the 3 months prior to pregnancy.
Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2006-2008. Analysis conducted by the Maternal and Child Health Information Resource Center.
Non-Hispanic White 53.1 33.3 27.5 24.1
Non-Hispanic Black 42.4 21.6 18.1 11.2
Hispanic 50.5 21.6 9.6 11.6
Non-Hispanic American Indian/Alaska Native 46.6 17.0 44.0 27.4
Non-Hispanic Asian 58.9 38.2 6.9 6.7
Non-Hispanic Native Hawaiian 48.7 22.2 26.2 23.4
Non-Hispanic Multiple Race 46.8 20.2 32.9 21.6
Total 51.1 29.7 22.3 18.8

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