Analysis of utilization and influencing factors of preconception healthcare services among women expecting additional childbirth in Jiading District, Shanghai

Abstract

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District, Shanghai, and to provide references for promoting the utilization of preconception healthcare services under the new population policy.MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District, Shanghai. The results were statistically analyzed.ResultsThe average age of the women was (31.7±4.5) years, 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low, at 16.4%. A significant majority, 92.4%, were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%, and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services, accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old (OR=1.789, 95%CI: 1.033‒3.099). Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy (OR=4.164, 95%CI: 2.627‒6.602). Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy (OR=7.534, 95%CI: 4.954‒11.456). Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services (OR=1.903, 95%CI: 1.083‒3.345).ConclusionUnder the context of three-child policy, the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age, whether the pregnancy was planned, whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs, especially for women of childbearing age who have not yet given birth, so as to improve the utilization rate of preconception health care services.

Keywords

• reproductive women
• preconception healthcare
• service utilization
• influencing factor
• three-child fertility rate