Abstract
Mental health distress (MHD) is broadly defined as an emotional state characterized by symptoms of stress, depression, and anxiety whereas preconception health embodies the physical and mental health prior to a pregnancy. MHD among women of reproductive age is associated with an increase in hypertension, diabetes, smoking, obesity, physical inactivity, and alcohol use. These risk factors have been identified as measurable indicators of preconception health. The purpose of the study is to examine the relationship between MHD and preconception health indicators after controlling for sociodemographic and healthcare access characteristics. The 2022 Florida Behavioral Risk Factor Surveillance System was used. Analysis was limited to women of reproductive age. The main exposure variable involved MHD. Women who reported their mental health not well for ≥ 14 days during the past month were characterized as enduring frequent MHD. Multiple logistic regression analyses were used to assess associations between MHD and each preconception health indicator in separate models. Among women of reproductive age, 22.2 % reported frequent MHD. Our findings showed that nonpregnant women of reproductive age who experienced frequent MHD had worse preconception health indicator outcomes than those with lower levels of MHD, with the greatest disparities detected in fair or poor self-rated health, and physical inactivity (AOR:3.31; p < 0.0001 and AOR:1.78; p = 0.0002, respectively). Older age, minority race, being uninsured, unemployed, divorced, having less than high school education, and financial barriers in healthcare access were associated with worse preconception health outcomes in most models. Increased screening and treatment for mental distress, counseling women about unhealthy behaviors, and adapting behavior change interventions may help optimize the preconception health of women with MHD. Personalizing interventions that would target these preconception modifiable risk factors could lead to improved short-term, long-term, and favorable pregnancy health outcomes among women with MHD.