Effects of preconception counseling on maternal health care of migrant women in China: a community-based, cross-sectional survey

BMC Pregnancy and Childbirth

Xu Qian²  Sufang Guo³  Ling Wang²  Yue Dai²  Aiping Peng²  Hong Jiang²  Jianmei Wu¹  Shiyun Hu²  Hui Tan²  Xiaofang You² 

[1] Pinghu Institute of Maternal and Child Health, Zhejiang Province, China;Department of Maternal and Child Health, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Mailbox 138, No. 138 Yi Xue Yuan Road, Shanghai 200032, People’s Republic of China;United Nations Children’s Fund China Country Office, Beijing, China

关键词: Migrant;    Folic acid supplements;    Quality prenatal care;    Preconception counseling;    Maternal health care;   

Others  :  1137782
DOI  :  10.1186/s12884-015-0485-4

 received in 2014-05-20, accepted in 2015-02-23,  发布年份 2015

【 摘 要 】

Background

Migrants have long been a disadvantaged group in China’s health care system, especially in terms of maternal health care. Many studies have explored the factors associated with a lack of maternal health care and found many determinants, including social, economic, behavioral, and environmental factors. However, studies focusing on factors associated with maternal health care have rarely examined preconception counseling (PCC). This study explored factors related to PCC uptake among migrant women, and investigated the association between PCC and maternal health care in migrant women.

Methods

A community-based cross-sectional study was conducted from July to December 2011, in Nanhai, Guangdong Province, and Pinghu, Zhejiang Province, China. A total of 1,012 migrant women who had their most recent pregnancy within 1 year of the survey answered a standardized interviewer-administered questionnaire about maternal health care. Descriptive statistics and multivariable logistic regression were used to analyze the data.

Results

Only 208 (20.6%, 95% confidence interval [CI]: 18.1–23.1%) of 1,012 migrant women had received PCC. Younger age, having more than one child, lack of knowledge of maternal health care and inter-province migration were predictors of a lack of PCC. PCC was associated with higher consumption of folic acid supplements during the preconception period (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.66–4.23). Among migrants who were resident in Nanhai or Pinghu for less than 5 years, PCC was related to better quality prenatal care (AOR = 3.07, 95% CI: 1.79–5.24).

Conclusions

The prevalence of PCC among migrant women was low (20.6%, 95% CI: 18.1–23.1%). Positive associations were found between the receipt of PCC and preconception folic acid supplements and quality prenatal care. Future studies focusing on maternal health care should pay attention to PCC and explore the effects of PCC on maternal health care through intervention studies. Continued efforts to increase PCC in migrants should target specific age groups (20–24 years), families with more than one child, and women who have migrated between provinces, as well as provide in-depth knowledge of maternal health care.

【 授权许可】

   
2015 You et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Chen J: Internal migration and health: re-examining the healthy migrant phenomenon in China. Soc Sci Med 2011, 72:1294-301.
• [2]National Bureau of Statistics of the People’s Republic of China. Main data of the sixth national population census. http://www.stats.gov.cn/ztjc/zdtjgz/zgrkpc/dlcrkpc/ (in Chinese).
• [3]Hu X, Cook S, Salazar MA: Internal migration and health in China. Lancet 2008, 372:1717-9.
• [4]Yuan B, Qian X, Thomsen S: Disadvantaged populations in maternal health in China who and why? Glob Health Action 2013, 6:19542.
• [5]Almeida LM, Caldas J, Ayres-de-Campos D, Salcedo-Barrientos D, Dias S: Maternal healthcare in migrants: a systematic review. Matern Child Health J 2013, 17:1346-54.
• [6]Kusuma YS, Kumari R, Kaushal S: Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India. Trop Med Int Health 2013, 18:1202-10.
• [7]Lauria L, Bonciani M, Spinelli A, Grandolfo ME: Inequalities in maternal care in Italy: the role of socioeconomic and migrant status. Ann Ist Super Sanita 2013, 49:209-18.
• [8]Singh PK, Rai RK, Singh L: Examining the effect of household wealth and migration status on safe delivery care in urban India, 1992–2006. PLoS One 2012, 7:e44901.
• [9]Bircher H: Prenatal care disparities and the migrant farm worker community. MCN Am J Matern Child Nurs 2009, 34:303-7.
• [10]Zhan SK, Sun ZW, Blas E: Economic transition and maternal health care for internal migrants in Shanghai, China. Health Policy Plan 2002, 171:47-55.
• [11]Liang J, Dai L, Zhu J, Li X, Zeng W, Wang H, et al.: Preventable maternal mortality: geographic/rural–urban differences and associated factors from the population-based Maternal Mortality Surveillance System in China. BMC Public Health 2011, 11:243. BioMed Central Full Text
• [12]Walfisch A, Koren G: Preconception counseling: rational, practice and challenges. Minerva Ginecol 2011, 63:411-9.
• [13]Ministry of Health: The job specification of preconception care (Trial). Ministry of Health, Beijing, China; 2007.
• [14]Qi H, Chang Q, Li L: Guideline for prenatal and antenatal health care. Chinese J Obstet Gynecol 2011, 46:150-3. (in Chinese)
• [15]Ministry of Health: Management practices and norms of maternal health care. Ministry of Health, Beijing, China; 2011.
• [16]Zhao X, Jiang X, Zhu J, Li G, He X, Ma F, et al.: Factors influencing the quality of preconception healthcare in China: applying a preconceptional instrument to assess healthcare needs. BMC Pregnancy Childbirth 2014, 14:360. BioMed Central Full Text
• [17]Chandranipapongse W, Koren G: Preconception counseling for preventable risks. Can Fam Physician 2013, 59:737-9.
• [18]Kermack AJ, Macklon N: Preconception care and fertility. Minerva Ginecol 2013, 65:253-69.
• [19]Czeizel AE: Experience of the Hungarian Preconception Service between 1984 and 2010. Eur J Obstet Gynecol Reprod Biol 2012, 161:18-25.
• [20]Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA: Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2010, 10:63. BioMed Central Full Text
• [21]WHO: Maternal, newborn and child health household survey guidelines (Draft). World Health Organization, Switzerland: Geneva; 2009.
• [22]Chen H, Xu H: The current situation, problem, and strategy for primary prevention of birth defects in Fengxian district in Shanghai city. Maternal Child Health Care China 2013, 28:5271-3. in Chinese
• [23]Ren Z: Utilisation of antenatal care in four counties in Ningxia, China. Midwifery 2011, 27:e260-6.
• [24]Gyampoh S, Otoo GE, Aryeetey RN: Child feeding knowledge and practices among women participating in growth monitoring and promotion in Accra, Ghana. BMC Pregnancy Childbirth 2014, 14:180. BioMed Central Full Text
• [25]Zhu H, Graham D, Teh RW, Hornbuckle J: Utilisation of preconception care in women with pregestational diabetes in Western Australia. Aust N Z J Obstet Gynaecol 2012, 52:593-6.
• [26]Williams L, Zapata LB, D’Angelo DV, Harrison L, Morrow B: Associations between preconception counseling and maternal behaviors before and during pregnancy. Matern Child Health J 2012, 16:1854-61.
• [27]Hosli EJ, Elsinga J, Buitendijk SE, Assendelft WJ, van der Pal-de BK: Women’s motives for not participating in preconception counseling: qualitative study. Community Genet 2008, 11:166-70.
• [28]Tang M, Wang D, Hu H, Wang G, Li R. Regional differences of maternal health care utilization in China. Asia Pac J Public Health 2013; May 10. doi:10.1177/1010539513487011.
• [29]Lyberg A, Viken B, Haruna M, Severinsson E: Diversity and challenges in the management of maternity care for migrant women. J Nurs Manag 2012, 20:287-95.
• [30]Pastuszak A, Bhatia D, Okotore B, Koren G: Preconception counseling and women’s compliance with folic acid supplementation. Can Fam Physician 1999, 45:2053-7.
• [31]Elsinga J, de Jong-Potjer LC, van der Pal-de BK, le Cessie S, Assendelft WJ, Buitendijk SE: The effect of preconception counselling on lifestyle and other behaviour before and during pregnancy. Womens Health Issues 2008, 18:S117-25.
• [32]Agricola E, Pandolfi E, Gonfiantini MV, Gesualdo F, Romano M, Carloni E, et al.: A cohort study of a tailored web intervention for preconception care. BMC Med Inform Decis Mak 2014, 14:33. BioMed Central Full Text
• [33]Belli RF: The structure of autobiographical memory and the event history calendar: potential improvements in the quality of retrospective reports in surveys. Memory 1998, 6:383-406.