Health-Related Preconception Factors: Adherence to Guidelines and Associations with Weight Status

Background: Knowing the percentage of women planning a pregnancy who meet preconception dietary and physical activity (PA) guidelines and which health-related preconception factors are associated with body mass index (BMI) could help improve preconception care.

Objectives: In a study conducted in women who were planning to conceive, the aims were to describe and compare eating and PA habits to current guidelines, as well as to identify the factors associated with BMI.

Design: This was a cross-sectional study.

Participants/setting: From 2017 to 2020, women planning to conceive within the next year (n = 217) were recruited in the province of Québec (Canada) to participate in the Apports Nutritionnels durant la GrossessE - Cohorte Contrôle study. Among them, 184 (84.8%) were included in the analyses.

Main outcome measures: Women completed three (90.2%) or two (9.8%) Web-based 24-hour dietary recalls and the International Physical Activity Questionnaire. Weight and height as well as the presence/absence of weight/body image concerns were self-reported. Eating and PA habits were compared with dietary reference intakes and Canadian guidelines, respectively.

Statistical analyses: Descriptive statistics were used to describe the sample, eating and PA habits, as well as adherence to guidelines. A multivariable regression analysis was performed to identify the factors associated with BMI.

Results: On average, women were aged 30.8 ± 4.1 years and identified as White (94.0%). Most of them had weight/body image concerns (58.7%), 54.6% of whom had a normal body weight. Overall, 42.3% engaged in 150 minutes/week or more of moderate-to-vigorous intensity PA and 84.8% consumed <135 g alcoholic beverages per week. Mean dietary intake was below Dietary Reference Intakes for carbohydrates, vitamins D and E, and above Dietary Reference Intakes for total fat and folic acid. Factors associated with a higher BMI were weight/body image concerns (β = 1.83; R² = 13.0%), higher dietary protein intake (β = .05; R² = 4.0%), lower income (β = .85; R² = 2.9%), no folic acid supplementation (β = .83; R² = 2.5%), spending less time in moderate-to-vigorous intensity PA (β = -.006; R² = 2.4%), eating <2 snacks (β = .75; R² = 2.2%), and <3 meals (β = 1.38; R² = 1.5%) daily.

Conclusion: Women planning to conceive do not have optimal eating and PA behaviors. Modifiable factors associated with BMI in preconception were identified.