BMC Med Inform Decis Mak - A cohort study of a tailored web intervention for preconception care.

Tópicos

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Resumo

CKGROUND: Preconception 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.METHODS: The 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.RESULTS: Of 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).CONCLUSIONS: Our 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.

Resumo Limpo

ckground preconcept care may efficaci tool reduc risk factor advers pregnanc outcom associ lifestyl health status pregnanc conduct webbas cohort studi italian women plan pregnanc assess whether tailor web intervent may chang knowledg behaviour associ risk advers pregnanc outcomesmethod studi entir conduct web cohort italian women childbear age data collect baselin health status lifestyl knowledg risk factor advers pregnanc outcom use generat tailor document includ recommend folic acid supplement obes underweight smoke alcohol consumpt vaccin chronic genet diseas exposur medic preval risk factor knowledg assess month intervent logist regress model use explor factor associ risk factor interventionresult enrol women complet studi month sinc deliveri tailor recommend baselin particip took folic acid supplement ci consum alcohol ci follow particip preconcept visit physician moreov observ decreas alcohol consumpt ci proport women take folic acid supplement ci observ improv knowledg inform preconcept behaviour prevent advers pregnanc outcom ci preconcept visit follow signif associ increas folic acid supplement ci conclus result suggest tailor web intervent may improv general preconcept health women plan pregnanc web preconcept intervent may integr classic preconcept care health profession clinic trial conduct confirm find

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