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
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.