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Abstract
Prenatal care (PNC) is a critical preventive health service for pregnant women and infants. Also, preconception care is recommended for all women of reproductive age. This study aimed to examine preconception care and its association with timeliness and adequacy of PNC. This retrospective cohort study used data from a large sample of U.S. first-time mothers (n=13,509) who participated in the 2009-2011 Pregnancy Risk Assessment Monitoring System in 10 states. Logistic regression was used to calculate odds ratios and 95% confidence intervals to model the association between preconception care receipt and the two PNC outcomes, as well as the association between preconception advice regarding folic acid, weight, smoking, and drinking, and the PNC outcomes. Women who received preconception care had statistically significant increased odds of timely (OR=1.30, 95% CI: 1.08, 1.57) and adequate PNC (OR=1.26, 95% CI: 1.05, 1.52) as compared to women who did not receive preconception care after adjustment for confounders. Preconception advice regarding specific topics was not associated with timely/adequate PNC. Given that untimely and inadequate PNC are associated with adverse birth outcomes, the observed associations provide further justification for implementing preconception care in all women of reproductive age. Future studies should investigate how specific components of preconception care are associated with PNC timeliness/adequacy, health behaviors during pregnancy, and birth outcomes.