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The Negative Pregnancy TestAn Opportunity for Preconception Care
Brian W. Jack, MD;
Christopher Campanile, MD, PhD;
William McQuade, MA, MPH;
Michael D. Kogan, PhD
Arch Fam Med. 1995;4(4):340-345.
Abstract
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Objective
To identify women who would likely benefit from preconception care.
Methods
A comprehensive preconception risk survey was administered during a structured interview to 136 women who had a negative pregnancy test visit in a family practice residency ambulatory practice. The survey solicited the presence of self-reported risk variables associated with maternal conditions related to poor obstetric outcome, risk factors for poor obstetric outcome, and risks for developing these conditions.
Results
Seventy women (51.5%) reported a medical or reproductive risk that could adversely affect pregnancy. In addition, 68 women (50%) reported a genetic risk; 39 (28.7%) reported a risk for human immunodeficiency virus infection, 35 (25.7%) reported an indication for hepatitis B vaccine, and an equal number reported recent use of illegal substances; 23 (16.9%) reported at least one affirmative answer to the CAGE questionnaire; 79 (58.5%) smoked cigarettes; 74 (54.4%) reported a nutrition risk; 126 (92.6%) reported a psychosocial risk; and 39 (28.7%) reported a perceived barrier to ongoing medical care. Even with the psychosocial risk category excluded, 94% of the women still reported at least one factor requiring further evaluation, counseling, or intervention before pregnancy.
Conclusions
We discovered a significant number of women with obstetric risk factors. A negative pregnancy test visit provides an opportunity for preconception risk assessment and counseling. These results will guide us to further develop practical preconception care protocols.
Author Affiliations
From the Department of Family Medicine, Brown University School of Medicine, Providence, RI (Drs Jack and Campanile and Mr McQuade); Blackstone Valley Community Health Care Inc, Pawtucket, RI (Dr Campanile); and the Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Md (Dr Kogan).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
NEGATIVE PREGNANCY TESTS: A TIME TO DO RISK ASSESSMENT
JWatch General 1995;1995:8-8.
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