Preconception health of low socioeconomic status women: assessing knowledge and behaviors

Womens Health Issues. 2011 Jul-Aug;21(4):272-6. doi: 10.1016/j.whi.2011.03.006. Epub 2011 May 24.


Introduction: The stalled U.S. infant mortality rate and persistent disparities in adverse pregnancy outcomes may be addressed by optimizing a woman's health throughout her childbearing years. This study examines women's knowledge and behaviors related to preconception risk factors in two community health centers serving lower income, racially diverse populations.

Methods: A survey was administered among a convenience sample of women ages 18 to 44 years (n = 340). Questions focused on health behaviors and conditions, knowledge of risk factors, and recommendations of health care providers. Outcomes include the prevalence of risk factors and correlations between the presence of a risk factor and either a respondent's knowledge or a health care provider's recommendation. Data were analyzed for total respondents and two subgroups: Black, non-Hispanic and Hispanic.

Results: Despite strong knowledge of risk factors in the preconception period, high-risk behaviors and conditions existed: 63% of women overweight or obese, 20% drinking alcohol, and 42% taking a multivitamin. Significant differences in risk factors were noted between Black, non-Hispanic and Hispanic respondents. Overweight/obesity (t = 3.0; p < .05) and alcohol use (χ² = 9.2; p < .05) were higher among Black, non-Hispanics, whereas Hispanic women had lower rates of multivitamin use (χ² = 11.1; p < .05). The majority of respondents recall being spoken to by a health care provider about pregnancy-related risks. Most risk factors were not influenced by provider's recommendations, including multivitamin use, drinking alcohol, and smoking. However, birth control use was correlated with a provider's recommendation (χ² = 7.6; p < .05). Correlations between the presence of risk factors and respondent's knowledge existed for immunizations (χ² = 9.6; p < .05), but not for multivitamin use, drinking alcohol, or smoking.

Conclusion: Our study identified behaviors amenable to change. Knowledge alone or a doctor's recommendation are not enough to change those behaviors. Innovative programs and support systems are required to encourage women to adopt healthy behaviors throughout the childbearing years.

MeSH terms

  • Adolescent
  • Adult
  • Alcohol Drinking
  • Chi-Square Distribution
  • Community Health Centers
  • Contraception
  • Ethnicity
  • Female
  • Health Behavior* / ethnology
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Immunization
  • Obesity / complications
  • Obesity / economics
  • Obesity / ethnology
  • Poverty*
  • Preconception Care* / economics
  • Pregnancy
  • Pregnancy Complications* / economics
  • Pregnancy Complications* / ethnology
  • Prevalence
  • Risk Factors
  • Risk-Taking*
  • Smoking
  • Social Class
  • United States
  • Vitamins
  • Young Adult


  • Vitamins