Preconception health indicators among women--Texas, 2002-2010

The first few weeks after conception are the most critical for fetal development; because most women are not aware that they are pregnant until after this critical period, health-care interventions should begin before conception. Promoting preconception health is an essential component of any broad strategy to prevent adverse pregnancy outcomes. Women who are planning pregnancy or could become pregnant should have a preconception health evaluation and adopt appropriate health behaviors. The Pregnancy Risk Assessment Monitoring System (PRAMS) tracks maternal behaviors, experiences, and health conditions, including preconception health. PRAMS is a state-specific, population-based surveillance system. The Texas Department of State Health Services analyzed PRAMS responses regarding preconception health of Texas women who delivered a live-born infant during 2002-2010. Among women who responded, 48% had no health-care insurance coverage before pregnancy and 46% reported an unintended pregnancy. In addition, 45% of the women reported consuming alcohol during the 3 months before pregnancy, and 18% reported binge drinking. Differences in demographic and socioeconomic variables were observed for the majority of preconception health indicators. Compared with non-Hispanic white women, non-Hispanic black and Hispanic women reported a 20% higher prevalence of not consuming a daily multivitamin and of being physically inactive, and approximately twice the prevalence of prepregnancy diabetes. Women without health-care coverage (public or private) before pregnancy generally were more likely to report unfavorable behavioral characteristics and health conditions compared with women with health-care coverage, regardless of whether the pregnancy was planned or not. Targeted public health interventions addressing the observed disparities in the preconception health and health care of women in Texas are needed.