Racial and Ethnic Disparities in Preconception Risk Factors and Preconception Care

Abstract

The high proportion of women of childbearing age with preconception risk factors highlights the need for preconception care. The common occurrence of multiple risk factors suggests the importance of developing screening tools and interventions that address risk factors that can lead to poor pregnancy outcomes. Increased attention should be given to high-risk subgroups.

“If You Don't Ask, I'm Not Going to Tell You”: Using Community-Based Participatory Research to Inform Pregnancy Intention Screening Processes for Black and Latina Women in Primary Care

“…Increasing attention to reproductive justice, cultural relevance, and patient-centered care has sharpened the focus on PI screening and its impact on patients' contraceptive decision making, particularly for women of low socioeconomic status (SES) and women of color, who are more likely to experience an unwanted or mistimed pregnancy (Finer & Zolna, 2016) and to be affected by preconception risk factors (Creanga et al, 2014;Denny et al, 2012), contributing to disparities in maternal and child health outcomes (Association of State and Territorial Health Officials, 2012;Bryant, Worjoloh, Caughey, & Washington, 2010;Mohllajee, Curtis, Morrow, & Marchbanks, 2007). Studies examining existing PI screening tools suggest that questions and response options may not address the complexity of women's intentions, feelings, desires, and life experiences regarding pregnancy, particularly for women of color or of lower SES (Bello et al, 2013;Borrero et al, 2015;Callegari et al, 2017).…”

Mechanisms of the Maternal Exposome and Implications for Health Outcomes

“…Additionally, multiple risk factors associated with preconception health have been associated with poor birth outcomes. For example, women with any of the following characteristics and behaviors have a higher risk of having poor birth outcomes: being underweight, obese, a smoker, excessive alcohol intake, increased levels of stress, diabetes, or poor dietary habits 62-65 . The biological mechanisms to explain these associations have yet to be identified…”

Interrupting Intergenerational Cycles of Maternal Obesity

“…Unplanned pregnancies are more common among minorities and women of lower socioeconomic status, who both have more preconception risks including obesogenic risk factors and are less likely to agree to be involved in research studies. [44–47] Although it is attractive to address preconception issues in the interpregnancy period, such studies miss the large proportion of women who have not yet had their first pregnancies. To date preconception cohort studies are rare, and no intervention studies of weight loss exist.…”