Materials and Methods: This cross-sectional study commenced in 2017 among women diagnosed as high-risk pregnancy in governmental health clinics in the state of Perak, Malaysia. Stratified random sampling was applied and interviewer-guided questionnaires were administered in this regard. A proforma and the validated Pre-pregnancy Care Knowledge and Practice Questionnaire were used, consisting 21 items on knowledge and 16 items on practice. The utilization of pre-pregnancy care services was defined if someone had attended the service at least once prior to the current pregnancy. Finally, logistic regression analysis was conducted using SPSS software.

Results: Of 490 women with high-risk pregnancies, 23.9% (n=117) utilized pre-pregnancy care services. Only one-third of them were aware of the offered services (33.1%), received advice to seek these services (30.4%), and were referred to the services (27.3%). There were four significant associated factors for the utilization of pre-pregnancy care services, including maternal age (P = 0.016), planned pregnancy (P < 0.001), family planning practice (P < 0.001), and pre-pregnancy care knowledge (P = 0.030).

Conclusions: The utilization of pre-pregnancy care services among women with high-risk pregnancy in this study was low. An increase in maternal age, a planned pregnancy, history of practicing family planning, and women with good pre-pregnancy care knowledge were more likely to utilize pre-pregnancy care services.