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Although the WHO and the Centers for Disease Control and Prevention (CDC) classify preconception health risks (PCHRs) into biomedical, behavioural and social categories, this classification remains theoretical, mainly inconsistent and lacks a scientifically robust framework. Data-driven clustering techniques may help clarify this complexity for policymakers and healthcare providers. This study aimed to assess the status of PCHRs and identify latent classes of these risks among women preparing for pregnancy.
This community-based cross-sectional study was conducted from 31 July to 16 August 2024 in Tigray, Ethiopia, among 865 married women planning to conceive within the next 6 months. Data were gathered through face-to-face interviews using a structured questionnaire. Risk factor indicators covering lifestyle behaviours, substance use, nutritional risks and related factors were developed based on guidelines from the WHO, the CDC and national recommendations. Latent class analysis (LCA) was employed to identify distinct classes of PCHRs, with the optimal number of classes determined using statistical fit indices, adequacy criteria and interpretability. The study also evaluated the overall distribution of PCHRs among participants.
The study took place in Tigray, Ethiopia, among married women intending to become pregnant within 6 months.
Burden of PCHRs and identified distinct latent classes of these risks within the participants.
All participants were exposed to at least four PCHRs, with 84.2% experiencing between 6 and 12 risk factors. The optimal LCA model identified four distinct classes of PCHRs: lifestyle behavioural risks (n=458, 52.9%), reproductive health risks and chronic medical conditions (n=106, 12.25%), nutritional risks and environmental exposure (n=149, 17.23%) and social determinants of health (n=152, 17.57%).
Our study reveals a high baseline level of PCHRs, with all participants exhibiting multiple risk factors for adverse pregnancy outcomes. The identification of four distinct risk profiles underscores the need for tailored risk-specific interventions, particularly in conflict-affected settings. Our findings point out the need for targeted preconception care and risk stratification in national health strategies to improve maternal and child health outcomes.
by Gebremedhin Gebreegziabher Gebretsadik, Andargachew Kassa Biratu, Alemayehu Bayray Kahsay, Amanuel Gessessew, Zohra S. Lassi, Hailemariam Segni, Afework Mulugeta
BackgroundAdverse pregnancy outcomes continue to pose a significant global public health challenge, especially in low- and middle-income countries. Although preconception care (PCC) interventions are advised to address this problem, their adoption remains inadequate, supported by scarce evidence particularly in conflict-impacted areas such as Tigray, Ethiopia, where rates of poor outcomes like neural tube defects are notably higher than in other regions. This study investigates the experience of pregnant women regarding the use of PCC in the Tigray, northern Ethiopia.
MethodsA community-based cross-sectional study was conducted from July 31 to August 16, 2024, involving 764 pregnant women in their first or second trimester. Participants were consecutively enrolled from clusters until the predetermined sample size was achieved. Data were collected through interviewer-administered questionnaires in accordance with World Health Organization, and Centers for Disease Control and Prevention, and national guidelines. PCC uptake was measured as the receipt of any service component (screening, counseling, or management) during healthcare consultations. We used SPSS version 27.0 to analyze PCC uptake and its associated factors. Descriptive and binary logistic regression statistics were used in the analysis. Finally, data was presented using text, tables, and figures as appropriate.
ResultsIn this study, the overall uptake of PCC services was 7.2%. All participants in the current pregnancy were exposed to at least one risk factor for adverse pregnancy outcomes. Factors such as women’s decision-making power, having information about PCC, HIV screening during the current pregnancy, and perceived susceptibility to preconception risks showed a statistically significant positive association with the uptake of PCC services.
ConclusionThe uptake of PCC services was very low. Addressing the low uptake of PCC services requires a multifaceted strategy, including public health campaigns via media and social forums, strengthened health extension programs, and the integration of a reproductive life plan tool to improve health-seeking behavior among women.
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