Pregnancy, risk behaviors and adverse reproductive outcomes: Is preconception care working in Italy?

Background: Preconception care guidelines and recommendations have been developed in many countries but, in Europe, recommendations for healthy couples are fragmented and not yet suitably implemented. Objectives: Our objective was to investigate, in a sample of Italian women who gave birth healthy babies in Northern Italy, the prevalence of performing preconception visit and the rate of risks and protective behaviours on adverse pregnancy outcomes, according to preconception visit. Materials and Methods: The study was a cross-sectional survey conducted in four maternity clinics in Northern Italy. After birth, women were asked to fill in a self-administered questionnaire on general characteristics, preconception visit, protective and risk factors (folic acid, immunization, BMI, smoking, alcohol, chronic diseases) before and during pregnancy. Results: 1077 women completed the questionnaire and were included in the analysis; 381 (35.4 %) underwent a preconception visit. Folic acid intake was significantly higher in the Preconception Visit Group (OR = 3.94, 95 % CI 2.7–5.7 and OR = 2.27, 95 % CI 1.7–3.1 - at least six months and one month before the last menstruation until the end of the first trimester - respectively). An increased number of women were vaccinated for rubella and chickenpox, had a BMI between 18.50–24.99 and were not smokers before pregnancy in the Preconception Visit Group. Conclusions: Our survey showed a limited use of the preconception visit among Italian women. It may represent a valid resource to improve the folic acid supplementation and immunization before pregnancy. More evidence is needed regarding the role of preconception visit on the risk factors requiring an integrated and long-term approach.