# Exploring the Unmet Need for Preconception Care and Its Effect on Biomarkers Among Married Nulliparous Women in Guntur, Andhra Pradesh: A Community-Based Cross-Sectional Study

## TL;DR

This study examines low awareness of preconception care among young married women in India and identifies factors influencing their knowledge.

## Contribution

The study provides new insights into the unmet need for preconception care and its predictors in a low-income Indian setting.

## Key findings

- Only 22.3% of participants had heard of preconception care.
- Multivariable analysis identified occupation and access to information sources as significant predictors of PCC awareness.
- Awareness of vaccination-related preconception care was very low (6.4%).

## Abstract

Background: In India, preconception care (PCC) is vital because the high rate of unplanned pregnancies raises the risk of complications for both mothers and newborns, and many young women lack adequate vaccination coverage before pregnancy. PCC is crucial for reducing adverse maternal-fetal outcomes. Still, knowledge and utilization of PCC remain very limited in many low- and middle-income settings. Evidence on the unmet need of PCC along with vaccination, lifestyle-related PCC, and biomarker associations in young women is limited in the Indian setting. This study explores the prevalence of PCC along with vaccination and nutrition-related PCC in nulliparous women.

Methodology: A community-based cross-sectional study was conducted from February to April 2025 in the outreach area of a primary health center in Guntur, Andhra Pradesh. Married nulliparous women aged 18-30 years were recruited using systematic sampling (n = 220). Data collection tools used included a pretested semi-structured questionnaire (including FIGO preconception checklist) and anthropometry. Statistical analysis included χ² tests and multivariable logistic regression to identify predictors of PCC awareness (IBM SPSS Statistics for Windows, Version 29 (Released 2024; IBM Corp., Armonk, New York, United States); p < 0.05 as statistically significant).

Results: Among 220 participants, only 49 (22.3%) had heard of PCC, and 14 (6.4%) were aware of vaccination-related PCC. Multivariable analysis showed that occupation of working vs. housewife with AOR 0.349 and 95% CI (0.062-1.968) and access to multiple information sources with AOR 0.007 and 95%CI (0.001-0.0035) were significant predictors of PCC awareness.

Conclusions: Awareness and utilization of vaccination and lifestyle-related PCC remain significantly low among young nulliparous women in South India. Integrating vaccination and lifestyle counseling into routine PCC at primary health centers, supported by frontline worker training, policy mandates, and community awareness campaigns targeting young women, could bridge critical gaps and improve pre-pregnancy health outcomes.