The preconception period (i.e., the period of time before an individual becomes pregnant) is increasingly recognized as a critical time period for health promotion. Preconception health interventions, including physician counseling, have demonstrated promise in encouraging health-promoting behaviors. This dissertation evaluates two historically understudied elements of preconception health, oral and sexual health, with an emphasis on generating insights to inform interventions. Our first study used latent class analysis in a population of preconception pregnancy planners to identify groups similar in terms of modifiable health behaviors. We then evaluated the extent to which group membership was associated with self-rated oral health and oral healthcare engagement to identify whether oral health-related behaviors clustered with other health behaviors in the preconception period. We found that healthy behaviors clustered into three groups, and that groups with higher probability of less healthy behaviors were less likely to be actively engaged in oral healthcare. Our second study estimated the effect of a history of preconception periodontitis on spontaneous abortion. We found that a self-reported history of adult tooth mobility was associated with a higher risk of spontaneous abortion, but that two other self-report measures of periodontitis (a history of diagnosis of and treatment for periodontitis) had no appreciable association. Finally, we evaluated the effect of preconception sexual dysfunction and distress on time to pregnancy. We report an association between lower sexual function, higher distress related to sexual function, and frequent painful intercourse and a prolonged time to pregnancy. The findings of these studies contribute insights into the salience of oral and sexual health in the preconception period and have the potential to inform interventions for preconception health promotion. / 2026-05-10T00:00:00Z
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48738 |
| Date | 11 May 2024 |
| Creators | Bond, Julia C. |
| Contributors | Heaton, Brenda |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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