Affiliation:
1. Department of Epidemiology Indiana University Richard M. Fairbanks School of Public Health Indianapolis Indiana USA
2. Department of Social and Behavioral Sciences Indiana University Richard M. Fairbanks School of Public Health Indianapolis Indiana USA
3. Department of Pediatrics Indiana University School of Medicine Indianapolis Indiana USA
4. Indiana University Melvin and Bren Simon Comprehensive Cancer Center Indianapolis Indiana USA
5. Center for Biomedical Informatics Regenstrief Institute, Inc. Indianapolis Indiana USA
Abstract
AbstractBackgroundLittle is known about the preconception/interconception health and behaviors of reproductive‐age women in the rural Midwest of the United States. The purpose of this study was to quantify preconception/interconception health status and to identify disparities compared with statewide estimates.MethodsIn this cross‐sectional study, we collected data on 12 health conditions and behaviors that are risk factors for adverse maternal and infant health outcomes from nonpregnant women ages 18‐45 years in rural northwestern Ohio. Statistical tests were used to identify associations between selected demographic characteristics and a subset of eight high‐priority health measures (smoking, diabetes, heavy alcohol use, folic acid intake, normal weight, sufficient physical activity, and effective contraception use); all but physical activity could be compared with Ohio estimates derived from the Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey.ResultsThree hundred‐fifteen women participated, with 98.4% reporting at least one high‐priority risk factor. Statistically significant differences were identified among subpopulations related to smoking, folic acid, normal weight, sufficient physical activity, and effective contraception use. In addition, the proportion of participants reporting hypertension (P < 0.001), smoking (P < 0.001), abnormal weight (P = 0.002), and lack of daily folic acid intake (P = 0.006) were statistically significantly higher than expected based on statewide estimates.ConclusionsWomen in the rural Midwest of the United States are at risk for poor health and pregnancy outcomes. Statewide estimates tracking preconception/interconception health status may obscure variation for at‐risk groups, particularly in rural or underserved areas. These findings illustrate the need for interventions to advance preconception/interconception health and improve methods to capture and analyze data for rural women.
Subject
Obstetrics and Gynecology
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