Preconception Care Receipt and Prepregnancy Hypertension Among Black Women in the United States: 2016-2021

Preconception care is individualized health care designed to optimize health prior to pregnancy to reduce future pregnancy complications. Promoting preconception care for preventing pregnancy-related illnesses and death is needed, especially for those who are at highest risk. This study evaluated reception of preconception care among U.S. Black women of reproductive age.

This study used Pregnancy Risk Assessment Monitoring System data from 2016 to 2021 with a sample of Black women across 44 states, the District of Columbia, New York City, and Puerto Rico who intended to become pregnant (n = 16,071). Multivariate logistic regression models evaluated the association between prepregnancy hypertension and preconception care reception.

Hypertensive Black women had 21% decreased odds (odds ratio [OR]: 0.79, confidence interval: 0.72-0.87) of receiving preconception care, compared with their counterparts without prepregnancy hypertension. An inverse dose-response was observed: As education and household income increased, the odds of receiving preconception care services decreased significantly (education: (OR: 1.39-0.64; income: OR: 0.74-0.30).

These findings affirm that hypertensive Black women had lower odds of receiving preconception care services compared with Black women who did not begin pregnancy with hypertension. Given that women with chronic conditions would have more reasons to receive care prior to pregnancy, this finding is disconcerting.