Preconception care: A screening tool for health assessment and risk detection

Background. Identification of risk factors for adverse pregnancy outcome is a main component of preconception care, but requires adequate time and knowledge. This study compares self-administered questionnaires to history taking by a physician to evaluate the reliability of such a screening tool for prepregnancy risk detection. Methods. One hundred ninety-three women from the outpatient clinic of Obstetrics and Gynecology of the University Medical Center Nijmegen, The Netherlands, were included in a study on preconception care. A Preconceptional Health Assessment form with risk variables pertaining to social, nutritional, medical, infectious disease, medication, reproductive and family history, and two Family History surveys (for the woman and her partner) were completed by 186 couples at home. A physician then orally verified the written answers. Agreement between the written and the oral answers was calculated using kappa statistic. Results. An excellent agreement level was found for all sections of the Preconceptional Health Assessment form (overall kappa = 0.88) except for nutritional history (kappa = 0.70). The Family History surveys also showed a high agreement level (kappa = 0.92 for women and kappa = 0.90 for men). Conclusions. The questionnaires are an accurate screening tool for preconceptional risk factors. We advocate their implementation in various settings to facilitate the provision of preconception care. (C) 2002 American Health Foundation and Elsevier Science (USA).