Psychosocial risk, prenatal counseling and maternal behavior: findings from PRAMS, 2004-2008

Am J Obstet Gynecol. 2013 Feb;208(2):141.e1-7. doi: 10.1016/j.ajog.2012.11.017. Epub 2012 Nov 15.

Abstract

Objective: To determine the impact of prenatal counseling regarding psychosocial risk factors on maternal behavior.

Study design: We analyzed data from 198,323 women participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). The χ(2) and logistic regression analyses assessed the relationship between psychosocial risk, prenatal counseling and maternal behavior.

Results: The odds of receiving risk-appropriate prenatal counseling were significantly greater for participants who used alcohol (odds ratio, 1.13; 95% confidence interval, 1.08-1.17) and tobacco (odds ratio, 2.02; 95% confidence interval, 1.91-2.13). After receiving counseling, women quit using alcohol (72.9% vs 27.1%; P < .01) and tobacco (79.9% vs 20.1%; P < .01) at a significantly greater rate and women with unintended pregnancies were more likely to use postpartum contraception (83.6% vs 16.4%; P < .01) than women who were not counseled. However, no significant differences were found in the rates of intimate partner violence during pregnancy (56.1% vs 43.9%; P = .09) between women who did and did not receive counseling.

Conclusion: Counseling regarding psychosocial risk factors during pregnancy may positively impact maternal behavior.

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology
  • Contraception / statistics & numerical data
  • Counseling*
  • Female
  • Humans
  • Logistic Models
  • Maternal Behavior / psychology*
  • Odds Ratio
  • Population Surveillance
  • Pregnancy
  • Prenatal Care*
  • Psychology
  • Risk Factors
  • Smoking / epidemiology
  • Spouse Abuse / statistics & numerical data
  • Surveys and Questionnaires
  • Young Adult