Psychosocial risk, prenatal counseling and maternal behavior: Findings from PRAMS, 2004-2008

Objective: To determine the impact of prenatal counseling regarding psychosocial risk factors on maternal behavior. Study Design: We analyzed data from 198,323 women participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). The χ² and logistic regression analyses assessed the relationship between psychosocial risk, prenatal counseling and maternal behavior. Results: The odds of receiving risk-appropriate prenatal counseling were significantly greater for participants who used alcohol (odds ratio, 1.13; 95% confidence interval, 1.08-1.17) and tobacco (odds ratio, 2.02; 95% confidence interval, 1.91-2.13). After receiving counseling, women quit using alcohol (72.9% vs 27.1%; P <.01) and tobacco (79.9% vs 20.1%; P <.01) at a significantly greater rate and women with unintended pregnancies were more likely to use postpartum contraception (83.6% vs 16.4%; P <.01) than women who were not counseled. However, no significant differences were found in the rates of intimate partner violence during pregnancy (56.1% vs 43.9%; P =.09) between women who did and did not receive counseling. Conclusion: Counseling regarding psychosocial risk factors during pregnancy may positively impact maternal behavior.