The Effect of Preconception Counselling on Women Lifestyle: A Randomized Control Trial

Abstract

Abstract: Background and Aim: Receiving preconception care and managing modifiable risk factors will lead to favorable pregnancy and childbirth outcomes. Preconception counseling is an important component of preconception care and preconception healthy lifestyle have a vital effect on women and next generation health. We aimed to examine the effect of preconception counselling on lifestyle (primary outcome) and knowledge on healthy lifestyle, locus of control and perceived stress (secondary outcome). Methods: This study was conducted on 152 women aged 18-35 who planned to get pregnant within the next year and who were presenting to health centers in Bonab, Iran, from March to November 2016. Using block randomization, the participants were assigned into a counselling and a control group (n=76 per group). The intervention group attended six group counseling sessions, twice per week, over three weeks; the topics such as nutrition and acid folic intake, physical activity and exercise, stress management, smoking or secondhand smoke exposure, environmental exposure, medication use, laboratory and screening tests, vaccination history and oral health were discussed in the sessions. The preconception lifestyle questionnaire, knowledge on healthy lifestyle questionnaire, the Multidimensional Health Locus of Control Scales (Internal Health Locus of Control, Powerful Others Health Locus of Control, Chance Health Locus of Control) and a checklist for preconception control and the Perceived Stress Scale, were completed by the participants before the intervention and four and eight weeks after the intervention. The repeated measure ANOVA was used to analyze the data. Result: A total of 70 participants in the intervention group and 72 in the control group ultimately were followed up and analyzed. The two groups were matching in terms of their socio-demographic characteristics and the baseline scores of preconception lifestyle and awareness about preconception lifestyle. According to the results of the repeated measure ANOVA with adjusting the baseline scores, the mean score of preconception lifestyle (Adjusted mean difference= 0.17; 95% Confidence Interval= 0.13 to 0.21) and awareness about preconception lifestyle (7.8; 8.7 to 6.9) showed statistically significant improvements in the intervention group compared to in the control group. A significant post-intervention increase in the mean score of the internal health locus of control in the intervention group compared to in the controls (Adjusted mean difference = 1.1; 95% Confidence Interval = 0.50 to 1.6 P<0.001) was seen. The mean score of the PHLC reduced in the counseling group compared to the control group, although not significantly (Adjusted mean difference = -0.24; 95% Confidence Interval = -0.94 to 0.45 P = 0.492). The mean score of the CHLC reduced significantly in the counseling group compared to the control group (Adjusted mean difference = -0.83; 95% Confidence Interval = -1.49 to -0.18 P = 0.013). After the intervention, the mean score of the preconception health locus of control increased significantly in the intervention group compared to in the controls and the mean score of perceived stress also decreased significantly in in the intervention group compared to in the controls (Adjusted mean difference = -1.3; 95% Confidence Interval = -0.56 to -2.1 P<0.001). Conclusion: preconception lifestyle group counseling is associated with increased awareness and improved lifestyle in women planning to get pregnant. Also, preconception counseling on lifestyle is associated with an increase in the internal locus of control and preconception locus of control and a reduction in chance locus of control and perceived stress in women intending to become pregnant. Incorporating preconception lifestyle group counseling sessions into the national routine PCC provided in health centers across the country to women planning to get pregnant appears to be effective in further improving the health status of mothers and infants.