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Preconception health is a national priority that focuses on improving birth outcomes, reducing the risk of infant mortality, and transforming the health of women before, during, between, and beyond pregnancy. North Carolina has been a leader in preconception health and continues to drive innovation nationwide. In collaboration with maternal and child health experts across the state, the Division of Public Health developed a strategic plan to address preconception health issues. The North Carolina Preconception Health Strategic Plan examines how energy and resources can best be invested to improve the health of North Carolina's women and children and offers new strategies to achieve this vision.
In an effort to measure and track the health status of women of childbearing age, a steering committee was established by the Public Health Work Group (PHWG) of the Centers for Disease Control and Prevention (CDC) Select Panel on Preconception Care. This steering committee researched, analyzed and developed a recommended list of Core State Preconception Health and Health Care Indicators. The tabular data collected below is designed to be the first step in reporting and tracking these preconception health measures for North Carolina in order to guide efforts to improve the health and wellness of women of reproductive age across the state.
| Domain | Sub-Domain | # | Indicator | Data source | Links to Data by Year |
|---|---|---|---|---|---|
| General Health Status & Life Satisfaction | Self-rated Health | A1 | Percentage of women who report good, very good or excellent health | BRFSS |
2021 |
| Social Determinants of Health | Education | B1 | Percentage of women with a high school education/GED or greater | BRFSS |
2021 |
| Poverty | B2 | Percentage of women who live at or below 200% of the Federal Poverty Threshold | ASEC | ||
| Health Care | Access to and Utilization of Health Care | C1 | Percentage of women who currently have some type of health care coverage | BRFSS |
2021 |
| C2 | Percentage of women having a live birth who had health care coverage during the month prior to pregnancy | PRAMS | |||
| C3 | Percentage of women who had a routine checkup in the past year | BRFSS |
2021 |
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| C4 | Percentage of women having a live birth who had a postpartum checkup | PRAMSa | Not Available in NC | ||
| C5 | Percentage of women having a live birth who had their teeth cleaned during the 12 months prior to pregnancy | PRAMS | |||
| C6 | Percentage of women who had a pap test within the past three years | BRFSS b,c | |||
| C7 | Percentage of women having a live birth who received preconception counseling about healthy lifestyle behaviors and prevention strategies from a health care provider prior to pregnancy | PRAMSa | Not Available in NC | ||
| Reproductive Health & Family Planning | Previous Preterm Birth | D1 | Percentage of women having a live birth who had a previous preterm birth | Vital Statistics Birth Certificate Data |
2015 |
| Previous Fetal Death, Miscarriage, or Stillbirth | D2 | Percentage of women having a live birth who had their previous live birth more than three weeks before the due date | PRAMS | ||
| D3 | Percentage of women who experienced a miscarriage, fetal death or stillbirth in the 12 months prior to getting pregnant with their most recent live born infant | PRAMSa | Not Available in NC | ||
| Inter-pregnancy Interval / Birth Spacing | D4 | Percentage of women having a live birth who had less than 18 months between their previous live birth and the start of the most recent pregnancy | Vital Statistics Birth Certificate Data | ||
| Pregnancy Intention / Wantedness | D5 | Percentage of women having a live birth who reported having an unintended or unwanted pregnancy Unintended pregnancy: percentage of women who said that just before their most recent pregnancy, they wanted to be pregnant later or didn’t want to be pregnant then or at anytime in the future Unwanted pregnancy: percentage of women who said that just before their most recent pregnancy they didn’t want to be pregnant then or at anytime in the future |
PRAMS | ||
| Contraception (Access, Availability, and Use) | D6 | Percentage of women having a live birth who were not trying to get pregnant at the time of conception and neither they nor their husbands or partners were doing anything to keep from getting pregnant | PRAMS | ||
| D7 | Percentage of women having a live birth who reported that they or their husbands or partners were currently doing something to keep from getting pregnant | PRAMS | |||
| Use of Assisted Reproductive Technology | D8 | Percentage of women having a live birth who used fertility drugs or received any medical procedures from a doctor, nurse, or other health care worker to help them get pregnant | PRAMSa | Not Available in NC | |
| Tobacco, Alcohol & Substance Use | Smoking | E1 | Percentage of women who currently smoke everyday or some days | BRFSS |
2021 |
| E2 | Percentage of women having a live birth who smoked cigarettes during the three months prior to pregnancy | PRAMS | |||
| Alcohol Consumption | E3 | Percentage of women who participated in heavy drinking on at least one occasion within the past month | BRFSS |
2021 |
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| E4 | Percentage of women who participated in binge drinking on at least one occasion in the past month | BRFSS |
2021 |
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| E5 | Percentage of women having a live birth who drank any amount of alcohol during the three months prior to pregnancy | PRAMS | |||
| E6 | Percentage of women years having a live birth who participated in binge drinking during the three months prior to pregnancy | PRAMS | |||
| Secondhand Smoke Exposure | E7 | Percentage of women having a live birth who reported that smoking is currently allowed in their home | PRAMS | ||
| Nutrition & Physical Activity | Fruit & Vegetable Consumption | F1 | Percentage of women who consume fruits and vegetables at least five times per day | BRFSSd | |
| Obesity and Overweight | F2 | Percentage of women who are overweight or obese based on body mass index (BMI) Overweight: percentage of women with a BMI ≥ 25 kg/m2 but < 30 kg/m2 Obesity: percentage of women with a BMI ≥ 30 kg/m2 |
BRFSS |
2021 |
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| F3 | Percentage of women having a live birth who were overweight or obese based on BMI at the time they became pregnant Overweight: percentage of women with a pre-pregnancy BMI ≥ 25 kg/m2 but < 30 kg/m2 Obesity: percentage of women with a pre-pregnancy BMI ≥ 30 kg/m2 |
PRAMS | |||
| Folic Acid Supplementation | F4 | Percentage of women having a live birth who took a multivitamin, prenatal vitamin, or a folic acid supplement everyday of the month prior to pregnancy | PRAMS | ||
| Exercise/Physical Activity | F5 | Percentage of women who participate in enough moderate and/or vigorous physical activity in a usual week to meet the recommended levels of physical activity | BRFSSd | ||
| Mental Health | General Mental Distress | G1 | Percentage of women who report that their mental health was not good for at least 14 out of the past 30 days | BRFSS |
2021 |
| Anxiety and Depression | G2 | Percentage of women having a live birth who visited a health care provider to be checked or treated for anxiety or depression during the 12 months prior to pregnancy | PRAMS | ||
| Postpartum Depression | G3 | Percentage of women having a live birth who experienced depressive symptoms after pregnancy | PRAMS | ||
| Emotional & Social Support | Domestic Abuse (Physical and Mental) | H1 | Percentage of women having a live birth who were physically abused by their partner during the 12 months prior to pregnancy | PRAMS | |
| H2 | Percentage of women having a live birth who were mentally abused by their partner during the 12 months prior to pregnancy | PRAMSa | Not Available in NC | ||
| Adequacy of Support | H3 | Percentage of women who always or usually get the social and emotional support they need | BRFSS | ||
| H4 | Percentage of women having a live birth who reported that they had adequate social and emotional support available to them after delivering their baby | PRAMSa | |||
| Chronic Conditions | Diabetes | I1 | Percentage of women who have ever been told by a health care provider that they had diabetes including gestational diabetes | BRFSS |
2021 |
| I2 | Percentage of women having a live birth who before their most recent pregnancy had ever been told be a health care provider that they had Type I or Type II diabetes | PRAMS | |||
| Hypertension | I3 | Percentage of women who have ever been told by a health care provider that they had hypertension including hypertension during pregnancy | BRFSSd | ||
| I4 | Percentage of women having a live birth who reported that they had hypertension during the 3 months before their most recent pregnancy | PRAMSa | Not Available in NC | ||
| Asthma | I5 | Percentage of women who currently have asthma | BRFSS |
2021 |
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| Infections | HIV | J1 | Percentage of women having a live birth who were tested for HIV within a year prior to their most recent pregnancy | PRAMSa | Not Available in NC |
| Sexually Transmitted Infections | J2 | Rates of Chlamydia, gonorrhea, and syphilis (cases per 100,000 women aged 18-44 years) | NSTD | ||
| Immunizations | J3 | Percentage of women who received an influenza vaccination within the past year | BRFSS |
2021 |
a Indicator measure is a PRAMS Standard Item, which is not available in all PRAMS states.
b Indicator measure is a BRFSS Rotating Core Item, which is available in all states only in even years.
c Indicator measure is also available as an Optional Module, which can be added in odd years.
d Indicator measure is a BRFSS Rotating Core Item, which is available in all states only in odd years.
The State of Preconception Health in North Carolina (PDF)
