Preconceptional health: Risks of adverse pregnancy outcomes by reproductive life stage in the Central Pennsylvania Women’s Health Study (CePAWHS)

This study used population-based data to examine how health status and risks vary by reproductive life stage, with particular focus on the proximal risks for preterm birth and low birthweight (LBW) infants in preconceptional and interconceptional women. Data are from the Central Pennsylvania Women’s Health Study (CePAWHS), which included a telephone survey of a representative sample of 2,002 women ages 18–45 years residing in largely rural central Pennsylvania. Women were classified according to reproductive stage—preconceptional, interconceptional, and postconceptional—on the basis of pregnancy history and reproductive capacity. Multiple indicators of health status and health risks were examined by reproductive stage, stratified by age group (ages 18–34 and ages 35–45). Results show that many risk factors varied significantly by reproductive stage and by age group within reproductive stage. Preconceptional and interconceptional women exhibited several unhealthy behaviors (e.g., binge drinking, nutritional deficits, physical inactivity). Younger pre- and interconceptional women (ages 18–34) had more gynecologic infections, some less favorable health behaviors, and more psychosocial stress than older women (ages 35–45) in the same reproductive stages. Older preconceptional women were more likely to have chronic conditions (hypertension, high cholesterol) than younger preconceptional women. Results suggest how interventions could be tailored to women’s reproductive stages.