Preconception Health

Narrative

Efforts to improve pregnancy outcomes and
the health of mothers and infants should begin
prior to conception, whether before a first or
subsequent pregnancy.1 As many women are not
aware of being pregnant at first, it is important
to establish healthy behaviors and achieve optimal
health well before pregnancy. Key indicators
of preconception health include not smoking
or abusing alcohol prior to pregnancy, taking a
daily multi-vitamin, and maintaining a healthy
weight.2

Frequent use of alcohol, especially early in
pregnancy, can cause fetal alcohol syndrome
and alcohol-related birth defects.3,4 Smoking
also increases the risk of pregnancy complications,
preterm birth, and low birth weight.5 In
2009–2010, about one in four recent mothers
in a 30-state area reported binge drinking (consuming
4 or more drinks in a sitting) at least
once within 3 months prior to pregnancy (26.6
percent) and 24.2 percent reported smoking
during the same time period. Smoking prior to
pregnancy varied by maternal education, ranging
from 9.6 percent of mothers with 16 or more
years of education to 34.3 percent of mothers
with 12 years of education. Binge drinking was
most common among mothers with 13-15 years
of education (31.9 percent), and least common
among those who had less than 12 years (16.3
percent). Binge drinking and smoking in the
three months prior to pregnancy also tend to
be more common among younger mothers. For
example, among 20- to 24-year-old women,
31.1 percent reported binge drinking in the 3
months prior to pregnancy and 35.3 percent
reported smoking, compared to 18.6 and 13.3
percent, respectively, among women aged 35
and older (data not shown in graph images or in data tables on this site).

Daily use of multi-vitamins containing folic
acid can reduce the risk of neural tube defects in
infants by two-thirds.6 In 2009-2010, only 30.1
percent of recent mothers reported daily multivitamin
use in the month prior to pregnancy.
With regard to maternal education, half (48.2
percent) of women with 16 or more years of education
reported taking a daily multi-vitamin in
the month prior to pregnancy compared to about
20 percent of women with 12 years or less.

Women should also attain a healthy weight
prior to pregnancy to prevent complications,
such as diabetes and hypertension, which may
increase the risk of preterm delivery.7 About
half of new mothers (50.1 percent) reported a
healthy pre-pregnancy weight. This proportion
varied by maternal age, with teenage mothers
being the most likely to have had a normal
pre-pregnancy weight (58.7 percent; data not shown in graph images or in data tables on this site). With respect to race and ethnicity,
Non-Hispanic Asian mothers were most likely
to have a healthy pre-pregnancy weight (66.2
percent, as compared to mothers of all other racial
and ethnic groups (data not shown in graph images or in data tables on this site).

1 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.↑

3 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.↑

5 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.↑

7 Centers for Disease Control and Prevention. Recommendations to improve preconception health and health care—United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. Morbidity and Mortality Weekly Review. 2006;55(No. RR-6). Accessed: 07/19/13.↑

Graphs

This image is described in the Data section.

Data

*Includes data from a total of 30 states and New York City; 25 states contributed both years. Mothers completed surveys between 2 and 9 months postpartum.↑**Defined as drinking 4 or more alcohol drinks in one sitting at least once in the 3 months prior to pregnancy.↑†Defined as a pre-pregnancy body mass index (ratio of weight to height) between 18.5 and 24.9.↑Source: Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System, 2009-2010. Analysis conducted by the Centers for Disease Control and Prevention, Division of Reproductive Health, National
Center for Chronic Disease Prevention and Health Promotion.

Information on this page can be found in the print version of Child Health USA 2013. Suggested Citation: U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child Health USA 2013. Rockville, Maryland: U.S. Department of Health and Human Services, 2013.