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Preconception health indicators in Northern Ireland (UK): A cross-sectional analysis of national maternity healthcare data in 255,117 pregnancies with a focus on deprivation
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  • Emma Cassinelli H,
  • Lisa Kent,
  • Kelly-Ann Eastwood,
  • Danielle Schoenaker,
  • Michelle McKinley,
  • Laura McGowan
Emma Cassinelli H
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences
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Lisa Kent
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences
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Kelly-Ann Eastwood
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences
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Danielle Schoenaker
University of Southampton School of Human Development and Health
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Michelle McKinley
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences
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Laura McGowan
Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences

Corresponding Author:laura.mcgowan@qub.ac.uk

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Abstract

Objective: To use routinely-collected maternity healthcare data to 1) describe the prevalence of key preconception indicators (e.g., smoking, folic acid supplement use) and 2) explore differences in prevalence by area-based level of deprivation. Design: Retrospective population-based study. Setting: Northern Ireland (NI). Population: 255,177 pregnancies recorded in the Northern Ireland MATernity System (NIMATS). Methods: Anonymised NIMATS data recorded during antenatal booking appointments (2011-2021) were accessed through the Honest Broker Service and analysed using R. Prevalences were calculated for each indicator, overall and based on deprivation quintile. Logistic regression models explored the relationships between each preconception indicator and area-level deprivation quintiles. Patient and Public Involvement and Engagement representatives helped prioritise indicators to include in the study, in conjunction with consulting the current evidence base, availability in NIMATS, and indicator modifiability. Main Outcome Measures: Preconception indicators, including behavioural factors (e.g., planned pregnancy), pre-existing health conditions (e.g., severe mental health), and area-based deprivation. Results: A high proportion of women had sub-optimal preconception indicators (e.g., 21.3% living with obesity). Women living in the most deprived quintile generally had a higher prevalence of risk factors than women in the least deprived quintile (e.g., smoking prevalence was 25.7% in the most deprived quintile and 5.6% in the least deprived quintile). Conclusions: Population-based maternity data in NI highlight many areas of women’s preconception health that require improvement and support, especially for women living in the areas of greatest deprivation. Findings are an essential reference point to inform interventions, policy, and ongoing monitoring of preconception health in NI.
11 Feb 2025Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 Feb 2025Submission Checks Completed
12 Feb 2025Assigned to Editor
12 Feb 2025Review(s) Completed, Editorial Evaluation Pending
17 Feb 2025Reviewer(s) Assigned