Patterns of Pre-pregnancy Care Usage among Reproductive Age Women in Kedah, Malaysia

  • Rozaimah ABU TALIB Kerian Health District, Parit Buntar, Perak, Malaysia
  • Idayu Badilla IDRIS Dept. of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Rosnah SUTAN Dept. of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Norizan AHMAD Family Health Development Division, Health Department of Kedah, Alor Star, Kedah, Malaysia
  • Norehan ABU BAKAR Bandar Baharu District Health Office, Kedah, Malaysia
Keywords: Pre-pregnancy care services, Usage, Determinant


Background: This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia. Methods: Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed. Results: The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.001), high education level (P<0.001), non-working mothers (P<0.001), multipara (P=0.001), awareness on the existence of pre-pregnancy care services in government health facilities (P<0.001), intention to use the services (P=0.0030), having medical illness (P=0.005), having social support (P=0.001), high knowledge (P<0.001), and positive perception (P<0.001). Conclusion: Low usage of pre-pregnancy care services can be improved through health screening on reproductive-aged women with positive determinant factors at the triage level in integrated clinics. Information and knowledge on pre-pregnancy services should be disseminated among community members through various means including roadshows and pre-wedding workshops.  


1. Boama V, Arulkumaran S (2009). Safer childbirth. A rights-based approach. Int J Gynaecol Obstet, 106 (2): 125-127.
2. Bhutta ZA, Dean SV, Imam AM, Lassi ZS (2011). A systematic review of preconception risks and interventions. Karachi: The Aga Khan University.
3. Lawn JE, Cousens S & Zupan J, et al (2005). Four Million Neonatal Deaths: When? Where? Why? Lancet, 365 (9462): 891-900.
4. World Health Organization (2013). Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity. World Health Organization, Geneva.
5. Annual Report (2013). Report of Family Health Development Division. Ministry of Health Malaysia. 2013. pp.: 23-55.
6. Kumar V, Mohanty S, Kumar A (2008). Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: A cluster-randomised controlled trial. Lancet, 372 (9644): 1151-1162.
7. Dean SV, Mason EM, Howson CP et al (2013). Born too soon: care before and between pregnancy to prevent preterm births: from evidence to action. Reprod Health, 10 (Suppl 1): S3.
8. Dean S, Rudan I, Althabe F et al (2013). Setting research priorities for preconception care in low-and middle-income countries: Aiming to reduce maternal and child mortality and morbidity. PLoS Med, 10(9): e1001508.
9. Family Health Report (2011). Report on Family Health Division, Kedah Health Department. pp.: 89-99.
10. Goldman JA, Dicker D, Feldberg D et al (1986). Pregnancy outcome in patients with insulin-dependent diabetes mellitus with preconceptional diabetic control: A comparative study. Am J Obstet Gynecol, 155(2): 293-297.
11. Wahabi HA, Alzeidan RA, Esmaeil SA (2012). Pre-Pregnancy care for women with pre-gestational diabetes mellitus: A systematic review and meta-analysis. BMC Public Health, 12: 792.
12. CEMACH (2005). Pregnancy in women with Type 1 and Type 2 diabetes in 2002–2003, England, Wales and North-ern Ireland. London: Confidential Enquiry into Maternal and Child Health, pp.: 98-115
13. Temple R (2011). Preconception care for women with diabetes: Is it effective and who should provide it? Best Pract Res Clin Obstet Gynaecol, 25(1): 3-14.
14. Hogan VK, Amamoo MA, Anderson AD et al (2012). Barriers to women's participation in inter-conceptional care: A cross-sectional analysis. BMC Public Health, 12: 93.
15. Wahabi HA, Alzeidan RA, Esmaeil SA (2012). Pre-Pregnancy care for women with pre-gestational diabetes mellitus: A systematic review and meta-analysis. BMC Public Health, 12: 792.
16. Steel A, Lucke J, Adams J (2015). The prevalence and nature of the use of preconception services by women with chronic health conditions: An integrative review. BMC Womens Health, 15: 14.
17. Corbett E. Preconception health and wellness (PHD Thesis): Knowledge and attitudes of undergraduate women. Tesis Colorado State University. 2011.
18. Ezegwui H, Dim C, Dim N, Ikeme A (2008). Preconception care in South Eastern Nigeria. J Obstet Gynaecol, 28(8): 765-768.
19. Najimudeen M, Sachchithanantham K (2014). An insight into low contraceptive prevalence in Malaysia and its probable consequences. Int J Reprod Contracept Obstet Gynecol, 3(3):493-496.
20. Malaysian population and family survey-1994 and 2004 (2014). National Popula-tion and Family Development Board (NPFDB), Kuala Lumpur.
21. Mazlina MN, Ruziaton H, Nuraini D et al (2014). Risk factors for women attending pre-pregnancy screening in selected clinics in Selangor. Malays Fam Physician, 9(3): 20–26.
22. Murphy HR, Temple RC, Ball VE et al (2010). Personal experiences of women with diabetes who do not attend pre‐pregnancy care. Diabet Med, 27(1):92-100.
23. Ezegwui HU, Dim C, Dim N, Ikeme AC (2008). Preconception care in South Eastern Nigeria. J Obstet Gynaecol, 28(8):765-8.
24. Coonrod DV, Bruce NC, Malcolm TD et al (2009). Knowledge and attitudes regarding preconception care in a predominantly low-income Mexican American Population. Am J Obstet Gyne-col, 200(6):686.e1-7.
25. Poppelaars FA, Henneman L, Adèr HJ et al (2004). Preconceptional cystic fibrosis carrier screening: Attitudes and intentions of the target population. Genet Test, 8(2): 80-89.
26. Squiers L, Mitchell EW, Levis DM et al (2013). Consumers' perceptions of preconception health. Am J Health Promot, 27(30): S10–S19.
27. Misra DP, Caldwell C, Young, AA, Abelson S (2010) Do fathers matter? Paternal contributions to birth outcomes and racial disparities. Am J Obstet Gynecol, 202(2):99-100.
28. Moos MK (2010). From concept to practice: Reflections on the preconception health agenda. J Women's Health (Larchmt), 19(3): 561-7.
29. Frey KA & Files JA (2006). Preconception healthcare: What women know and believe. Matern Child Health J, 10(Suppl 1): 73–77.
30. Wickremasinghe V, Prageeth P, Pulleperuma D, Pushpakumara K (2003). Preconceptional care of women at booking visit at De Soysa Maternity Hospital and Castle Street Hospital for Women. Ceylon Med J, 48(3): 77-79.
31. Chuang CH, Velott DL & Weisman CS (2010). Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Matern Child Health J, 14(5):713-719.
32. Van Der Zee B, De Beaufort ID, Steegers EA, Denktaş S (2013). Perceptions of preconception counselling among women planning a pregnancy: A qualitative Study. Fam Pract, 30(3):341-6.
33. Temel S, Birnie E, Sonneveld HM et al (2013). Determinants of the intention of preconception care use: Lessons from a multi-ethnic urban population in the Netherlands. Int J Public Health, 58(2):295-304.
How to Cite
ABU TALIB R, IDRIS IB, SUTAN R, AHMAD N, ABU BAKAR N. Patterns of Pre-pregnancy Care Usage among Reproductive Age Women in Kedah, Malaysia. Iran J Public Health. 47(11):1694-1702.
Original Article(s)