Preconception care practices, documentation, and missed opportunities among women with overweight and obesity: a retrospective study

Abstract

Despite the importance of preconception care, it remains underutilized and inconsistently documented. The aim of this study was to assess preconception care practices, documentation patterns, and risk profiles among women with overweight and obesity. A retrospective chart review was conducted among pregnant women aged 18–45 years with a body mass index (BMI) of ≥ 25 kg/m², who attended outpatient clinics within three–six months prior to conception. The data collected included encounter type, patient eligibility, demographic characteristics, clinical risk factors, laboratory results, and documentation of preconception counseling components such as pregnancy intention, folic acid prescription, lifestyle counseling, medication review, and immunization status. Descriptive statistics were used to summarize the findings. Additionally, chi‑square tests were used to examine associations between each preconception care component and encounter type and eligibility. A total of 365 patient records were eligible for analysis. The mean age was 32.51 years (SD 5.58), with 55.1% aged 30–39 years. Obstetric (OB) visits accounted for 77.0% of the encounters, and 67.9% were referred/emergency department (ED) patients. The mean body mass index (BMI) was 31.09 kg/m² (SD 4.61). Most women were either overweight (40.5%) or had class I obesity (39.2%). Documentation of key PCC components was inconsistent, with missed opportunities identified in risk assessment, lifestyle counseling, and preventive screening. Preconception care remains underutilized and inconsistently documented among women with overweight and obesity. The large proportion of women who presented for the first time during antenatal care highlights important missed opportunities for preventive intervention prior to pregnancy. Not applicable.