Preconception health status of women, 18-45 years, in Trinidad: A cross-sectional study

BACKGROUND: Despite overwhelming evidence that preconception care (PCC) has the promise to improve the health and welfare of women, infants, and children; it is not routinely undertaken nor recommended to the population of Trinidad and Tobago. This study assessed maternal health status prior to conception by means of a screening tool, physical measurements and laboratory samples in Trinidad. METHODS: A cross-sectional study was conducted among women, aged 18-45, at a primary care centre in Arima, Trinidad, between December 4 th 2016 and January 14 th 2017. A de novo PCC screening tool assessed 13 domains of high-risk pregnancy in participants. Blood pressure, weight, height and waist circumference were recorded, and a capillary blood sample determined random blood glucose and HbA1c. All data were coded and entered into SPSS ver. 21. RESULTS: A total of 400 women were recruited. 366 were included in the final analysis. Most ( 96.7%) had one or more risk factors for adverse pregnancy outcomes. These included overweight (BMI ≥ 23) 26.8%, obese (BMI ≥ 27.5) 47.5%, central obesity (WC ≥ 80cm) 69.4%, Impaired Glucose Tolerance/ Diabetes mellitus (IGT/DM) (HbA1C ≥ 5.7) 26.2%, sedentary lifestyle 74.9%, diet high in processed food/fats 88.8%. Only 13.1% had planned to conceive and of those who had no immediate plans of conceiving 76.4% were sexually active and most (60.7%) did not use birth control techniques. More than half (57.1 %) never had a PAP smear. On the other hand, 86.3% knew their HIV status. Self-reporting percentages for vaccination were as follows: 100% had received vaccination for MMR but only 17.5% for tetanus, 11.5% for Hepatitis B and 2.7% for influenza. The vast majority (82.8%) had not visited the dentist in the past year with 35.9% of these exhibiting signs of periodontitis. CONCLUSIONS: The majority of participants had a risk factor for an adverse pregnancy outcome. There is a need for enhanced preconception care for women in Trinidad.