Alberto Eugenio Tozzi*, Ospedale Bambino Gesù, Rome, Italy, Rome, Italy Eleonora Agricola, Ospedale Bambino Gesù, Rome, Italy, Rome, Italy Mariateresa Romano, Ospedale Bambino Gesù, Rome, Italy, Rome, Italy Francesco Gesualdo, Ospedale Bambino Gesù, Rome, Italy, Rome, Italy Elisabetta Pandolfi, Ospedale Bambino Gesù, Rome, Italy, Rome, Italy Pierpaolo Mastroiacovo, International Clearing House for Birth Defects, Rome, Italy Track: Research Presentation Topic: Web 2.0 approaches for behaviour change, public health and biosurveillance Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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Background
Adverse pregnancy outcomes (ARO) are a group of adverse and partially preventable conditions that could affect both mother and child health before, during, and after pregnancy. It has been demonstrated that the ARO risks factors could be reduced through preconception counselling to childbearing women and their partners before pregnancy. Preconception counselling includes several recommendations such as smoke and alcohol cessation, folic acid supplementation, review and update of vaccinations, appropriate management and therapy of chronic diseases, and others. Considering the wide use of the Internet by women to search information on fertility, getting pregnant, and pregnancy, we set up a web platform for women of childbearing age to 1) measure prevalence of risk factors for ARO; 2) provide personalized information on prevention of ARO; 3) and to study the efficacy of such intervention.

Methods
We reviewed the current literature to identify a set of preventative actions that are demonstrated to be efficacious in preventing ARO. A web campaign on Italian social networks invited women of childbearing age planning a pregnancy in the forthcoming year, to participate in a cohort study totally conducted on the web. Once enrolled in the study, women were required to fill in a questionnaire to detect risk factors for ARO and to measure knowledge, attitude, and practice toward preventative actions. Information collected through the questionnaire were used for creating a personal profile and to automatically generate a downloadable document with the history of the woman, and a set of personalized recommendations based of information provided. Women were also invited to communicate if they got pregnant in the following 6 months. After a six month period, participants were invited to fill in the same questionnaire provided at enrolment to measure the impact of the intervention with a before-after approach.

Results
In the first four months of the study, we have enrolled 305 women in childbearing age. 74,4% of them are planning their first pregnancy. Regarding the risk factors prevalence, we observed that 16,4% of the women is overweight or obese; 72,8% of them take medicines regularly; 10.8% stated they had previous birth defects in their family; 8.9% had miscarriages; and 3.9% had abortions for medical purposes. We also observed that alcohol assumption is more frequent than smoking (63.0% vs 16,7%) and that 42,6% of the women take folic acid supplementation daily. While enrollment is ongoing, follow up of women after 6 months of the intervention, will be completed starting March 2012.

Conclusions
This study shows that prevalence of risk factors for ARO is high in the general population of women of childbearing age. Prevention strategy should be tailored to personal profiles when possible. Personalized counselling through the web represents a feasible and affordable approach to deliver recommendations based on evidence.