Jusoh, Nazirah
(2018)
Knowledge and practice of preconception health, perception and experience of utilising preconception care and its association with early antenatal booking among women with high risk pregnancy in Kinta District, Perak.
Masters thesis, Universiti Sains Malaysia.
Abstract
Knowledge and practice of preconception health, perception and experience of
utilising preconception care and its association with early antenatal booking
among women with high risk pregnancy in Kinta District, Perak.
Preconception care is a promising new approach to improve the health of future
children through primary intervention and to ensure appropriate action and avoid risks
in early pregnancy. A greater number of women are being categorized as high risk
pregnancies due to shift in maternal age and obesity prevalence. This study aims to
determine the preconception health knowledge and practice, factors associated with
early antenatal booking and to explore the experiences and perceptions of
preconception care among antenatal women with high risk pregnancy in Kinta
District, Perak. This is a mixed-method study comprising of a quantitative crosssectional
survey and an exploratory qualitative study. A cross-sectional survey was
conducted between March and December 2016 at 14 health clinics in Kinta District,
Perak. Women who came for their first antenatal booking were randomly selected. A
validated interviewer guided questionnaire was administered. It consisted of three
domains, assessing sociodemographic data, knowledge and practice of preconception
care. Knowledge score of more than 12 was categorized as good knowledge, and
practice score of more than 8 was considered as good preconception practice. The
qualitative study using focus group discussion and in-depth interview were conducted
among women with high risk pregnancy selected through purposive sampling among
those who had participated in the quantitative survey. A total of 490 respondents
participated in the study. The mean age was 29.9 (SD 5.56) years old. Majority of
respondents were Malay 347 (70.8%). Only 23.9% of respondents attended
preconception care. About 48.6% of the respondents had good knowledge and 76.7%
had good practice of preconception health. The proportion of those who attended
early antenatal booking was 74.3%. The significant factors found to be associated
with early antenatal booking were women who attended preconception care (Adj. OR:
1.54; 95% CI: 1.30, 3.98; p=0.043), planned pregnancy (Adj. OR: 2.21; 95% CI:
1.42, 3.45; p<0.001) and preconception health practice (Adj. OR: 1.88; 95% CI: 1.17,
3.01; p=0.009). There were three major themes emerged from the interview which
are: women’s perceived preconception care is for family planning, preconception care
is indicated for women with high risk pregnancy and preconception care as for
preparation for the next pregnancy. Women who attended preconception care
experienced long waiting time from the registration to the consultation, lack of
privacy and confidentiality, and preferred to be seen by female doctors. Proportion of
antenatal women with high risk pregnancy who attended preconception care were low
and they had fair knowledge on preconception health. Most of the respondents’
perception of preconception care was incomplete. Strategies should focus on
improving the low level of knowledge as well as misconception about preconception
care as identified in this study.
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