Temporal trends of key preconception indicators among women in Northern Ireland, UK: An analysis of maternity healthcare data 2011-2021
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Background
Optimising preconception health offers an opportunity to reverse unfavourable trends in modifiable risk factors and improve reproductive outcomes. This study aims to report the yearly prevalence of key biopsychosocial preconception indicators for over a decade, as reported at antenatal booking appointments in Northern Ireland (UK). The indicators include area-level deprivation, planned pregnancies, smoking, and body mass index (BMI) between 2011 and 2021, as well as pre- and early-pregnancy folic acid supplement use between 2015 and 2020.
Methods
This population-based study was conducted using annual routinely collected maternity data from the Northern Ireland Maternity System (NIMATS). R, accessed via the UK Secure eResearch Platform, was used to calculate yearly proportions. Multinomial regression models explored the relationship between each preconception indicator and year of booking appointment. Patient and Public Involvement and Engagement strategies were integrated throughout the study.
Results
The findings highlighted diverging trends over the study period; for example, smoking prevalence decreased (16.7%-9.6%), while obesity increased (e.g., obesity class I: 12.0%-16.1%). Preconception folic acid supplement use remained inadequate among women in NI, though the use of supplements containing 5mg of folic acid increased between 2015 and 2020 (400µg: 34.4%-30.03%; 5mg: 3.6%-5.0%).
Conclusions
Efforts are needed to reverse negative public health consequences of sub-optimal preconception health indicators. Notably, folic acid supplement use was predominantly initiated after conception, suggesting that a renewed focus is needed, particularly supporting women with the greatest need, such as those living in the most deprived areas.
