• Joline Goossens, Dimitri Beeckman, Ann Van Hecke, Ilse Delbaere, and Sofie Verhaeghe.
• University Centre for Nursing&Midwifery, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium. Electronic address: Jolgooss.Goossens@UGent.be.
• Midwifery. 2018 Jan 1; 56: 112-120.

Objectives(1) to study preconception lifestyle changes and associated factors in women with planned pregnancies; (2) to assess the prevalence of risk factors for adverse pregnancy outcomes in women not reporting any preconception lifestyle changes; and (3) to explore the need for and use of preconception-related advice.Designsecondary data analysis of a cross-sectional study about pregnancy planning.Settingsix Flemish Hospitals (Belgium).Participantsfour hundred and thirty women with a planned pregnancy ending in birth.Measurementspreconception lifestyle changes were measured during the first 5 days postpartum using the validated London Measure of Unplanned Pregnancy. The following changes were assessed: folic acid or multivitamin intake, smoking reduction or cessation, alcohol reduction or cessation, caffeine reduction or cessation, eating more healthily, achieving a healthier weight, obtaining medical or health advice, or another self-reported preconception lifestyle change.Findingsmost women (83%) that planned their pregnancy reported ≥1 lifestyle change in preparation for pregnancy. Overall, nulliparous women (OR 2.18, 95% CI 1.23-3.87) and women with a previous miscarriage (OR 2.44, 95% CI 1.14-5.21) were more likely to prepare for pregnancy, while experiencing financial difficulties (OR 0.20, 95% CI 0.04-0.97) or having a lower educational level (OR 0.56, 95% CI 0.32-0.99) decreased the likelihood of preparing for pregnancy. Half of the women (48%) obtained advice about preconception health, and 86% of these women received their advice from a professional caregiver. Three-quarters (77%) of the women who did not improve their lifestyle before conceiving reported one or more risk factors for adverse pregnancy outcomes.Key Conclusions And Implications For Practicemultiparous women and women of lower socio-economic status were less likely to change their lifestyle before conception. Strategies to promote preconception health in these women need to be tailored to their needs and characteristics to overcome barriers to change. It may be advantageous to reach these women through non-medical channels, such as schools or other community organizations.Copyright © 2017 Elsevier Ltd. All rights reserved.

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