The Colorado Department of Public Health and Environment (CDPHE) Maternal Wellness Team, Health Statistics Section and Epidemiology, Planning and Evaluation Branch  published a CDPHE Health Watch titled, How Healthy Are Colorado Women of Reproductive Age? An Evaluation of Preconception Risk and Protective Factors.  The purpose of the report is to examine preconception health among Colorado women of reproductive age.  The report describes preconception risk and protective factors related to maternal and infant health outcomes among Colorado women ages 18 to 44 using data gathered from the Colorado Behavioral Risk Factor Surveillance System for years 2004 through 2006.  Risk factors in the analysis include smoking, obesity, poor mental health and alcohol use.  Protective factors include eating well, taking folic acid and exercising.

Many Colorado women of reproductive age engage in a variety of behaviors that are unhealthy.  Substantial proportions of women smoke tobacco (20 percent), are overweight or obese (42 percent), suffer from poor mental health (45 percent), and use alcohol (59 percent). Some women take steps to improve or maintain their health by eating fruits and vegetables (27 percent) and many more do so by exercising (57 percent) and taking folic acid (42 percent).

Analyses of the data also identified differences by age group (18 to 29 years and 30 to 44 years), ethnicity (Hispanic and non-Hispanic), and when a child was desired (within two years and two or more years). Young women are less likely to be overweight or obese, but they are also more likely to binge drink.  Risk factors are less prevalent among Hispanic women, but protective factors are less prevalent in this population as well.  Overall, women who desire a child in the near future are just as likely to smoke, be overweight or obese, report poor mental health, drink alcohol and binge drink as women who want to wait at least two years before having a child.  In addition, women are not improving their health by eating well, taking folic acid daily, and regularly exercising moderately or vigorously.  These findings highlight the importance of preconception health and its clear message that women of reproductive age should minimize risk factors and maximize protective factors during their reproductive years.  In so doing they will improve their own health and contribute to the health of the next generation. 

In Colorado, 39 percent of births result from pregnancies that are unplanned, and thousands of women are at risk for unintended pregnancy. Whether pregnancies are planned or unplanned, the health of the mother affects  the health of the child.  Improving preconception health requires changes in knowledge, attitudes and behaviors of individuals, families, communities and institutions.  Incorporating components of preconception health into clinical practice protocols and existing public health programs can help women modify risk factors and promote protective factors.  By encouraging healthy behaviors before pregnancy, prevention experts have the opportunity to help women attain optimal health over a lifetime and across generations.

The Colorado Healthy Women Healthy Babies and Health TeamWorks developed preconception and interconception clinical practice guidelines for health care providers to use during every office visit.  The Colorado Department of Public Health and Environment is developing, evaluating, and disseminating a life plan booklet designed to educate and help women set life goals, including plans for having children in the future, and to consider preconception health factors even if they do not desire future pregnancy.

The link to the Colorado Health Watch No. 78 article is http://www.cdphe.state.co.us/hs/hspublications.html.