A cohort study of a tailored web intervention for preconception care

BMC Medical Informatics and Decision Making

Research Article

Pierpaolo Mastroiacovo¹  Alberto E Tozzi²  Michaela V Gonfiantini²  Francesco Gesualdo²  Elisabetta Pandolfi²  Emanuela Carloni²  Eleonora Agricola²  Mariateresa Romano³ 

[1]Alessandra Lisi International Centre on Birth Defects and Prematurity, Via Carlo Mirabello 14, 00192, Rome, Italy

[2]Bambino Gesù Children’s Hospital IRCCS, Epidemiology Unit, Piazza S. Onofrio 4, 00165, Rome, Italy

[3]Department of Onco-Ematology and Transplantation Medicine, Bambino Gesù Children’s Hospital IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy

关键词: Preconception care;    Preconception health;    Preconception counselling;    Adverse pregnancy outcomes;    Folic acid;    Web intervention;    Internet;    Lifestyles;   

DOI  :  10.1186/1472-6947-14-33

 received in 2013-10-11, accepted in 2014-04-07,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundPreconception care may be an efficacious tool to reduce risk factors for adverse pregnancy outcomes that are associated with lifestyles and health status before pregnancy. We conducted a web-based cohort study in Italian women planning a pregnancy to assess whether a tailored web intervention may change knowledge and behaviours associated with risks for adverse pregnancy outcomes.MethodsThe study was entirely conducted on the web on a cohort of Italian women of childbearing age. Data collected at baseline on health status, lifestyles and knowledge of risk factors for adverse pregnancy outcomes were used for generating a tailored document including recommendations for folic acid supplementation, obesity and underweight, smoking, alcohol consumption, vaccinations, chronic and genetic diseases, exposure to medications. Prevalence of risk factors and knowledge was assessed 6 months after the intervention. Logistic regression models were used to explore the factors associated with risk factors after the intervention.ResultsOf the 508 enrolled women, 282 (55.5%) completed the study after 6 months since the delivery of tailored recommendations. At baseline, 48% of the participants took folic acid supplementation (95% CI 43.2; 51.9) and 69% consumed alcohol (95% CI 64.7; 72.9). At the follow up 71% of the participants had a preconception visit with a physician. Moreover we observed a decrease of alcohol consumption (−46.5% 95% CI −53.28; −38.75) and of the proportion of women not taking folic acid supplementation (−23.4% 95% CI −31.0; 15.36). We observed an improvement in knowledge of the information about the preconception behaviours to prevent adverse pregnancy outcomes (20.9% 95% CI 14.6%; 27.1%). Having a preconception visit during follow up was significally associated to an increase in folic acid supplementation (OR 2.53 95% CI 1.40; 4.60).ConclusionsOur results suggest that a tailored web intervention may improve general preconception health in women planning a pregnancy. A web preconception intervention may be integrated with classic preconception care by health professionals. Clinical trials should be conducted to confirm these findings.

【 授权许可】

CC BY   
© Agricola et al.; licensee BioMed Central Ltd. 2014