Determining Pre-Conception Risk Profiles Using a National Online Self-Reported Risk Assessment: A Cross-Sectional Study

Abstract

Aim: To measure the prevalence of health risk factors in women who are preparing for pregnancy, using an online publicly available questionnaire aimed at identifying personal and pre-conception risks and at providing tailored information. Methods: A nation-wide available, free, web-based, self-reported questionnaire for pre-conception use (in Dutch). Between May 2006 and August 2009, 89,946 questionnaires were completed (78,732 were from unique respondents) and available for research purposes, from which those of non-pregnant women (n = 66,617) were selected. Socio-demographic subgroups were distinguished by age, ethnicity, urban living area and living in a deprived neighbourhood. The four pre-conception risk domains were lifestyle, medical, reproductive and family history; together they were defining the risk profile. χ2 tests were used to compare the risk profiles among the subgroups. Results: The prevalences of the reported risk factors are given. The risk factor profiles revealed that the average, responding, non-pregnant, Dutch woman is exposed to a substantial number of risk factors. Different risk profiles were observed in the different socio-demographic subgroups. Women older than 36 years, of non-Western origin, living in urban areas and those in deprived neighbourhoods showed higher risk profiles, based on a larger number of risks, with significantly higher prevalences. Conclusion: Self-reported data from a large, self-selected, non-pregnant population who actively visited a web-site for reproductive information suggest the need for active general pre-conception care as risk factors were abundant. A considerable increase in attention for pre-conception care is justified; different subpopulations most likely require adapted approaches.