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Lancet. 2019 Jun 1;393(10187):2262-2271. doi: 10.1016/S0140-6736(19)30954-7.

Preconception health in England: a proposal for annual reporting with core metrics.

Author information

1
Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK. Electronic address: judith.stephenson@ucl.ac.uk.
2
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
3
Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.
4
Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK.
5
Public Health England, London, UK.
6
Southampton Education School, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK.
7
Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK; Royal College of General Practitioners, London, UK.
8
School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, St Thomas Hospital, London, UK.
9
NIHR Southampton Biomedical Research Centre, MRC Lifecourse Epidemiology Unit (University of Southampton), University Hospital Southampton, Southampton, UK.
10
Institute of Developmental Sciences, University of Southampton, Southampton, UK.
11
Department of Economics and Department of Social Science, University College London, London, UK.
12
Global Health Epidemiology and Evaluation, UCL Institute for Global Health, University College London, London, UK.

Abstract

There is growing interest in preconception health as a crucial period for influencing not only pregnancy outcomes, but also future maternal and child health, and prevention of long-term medical conditions. Successive national and international policy documents emphasise the need to improve preconception health, but resources and action have not followed through with these goals. We argue for a dual intervention strategy at both the public health level (eg, by improving the food environment) and at the individual level (eg, by better identification of those planning a pregnancy who would benefit from support to optimise health before conception) in order to raise awareness of preconception health and to normalise the notion of planning and preparing for pregnancy. Existing strategies that target common risks factors, such as obesity and smoking, should recognise the preconception period as one that offers special opportunity for intervention, based on evidence from life-course epidemiology, developmental (embryo) programming around the time of conception, and maternal motivation. To describe and monitor preconception health in England, we propose an annual report card using metrics from multiple routine data sources. Such a report card should serve to hold governments and other relevant agencies to account for delivering interventions to improve preconception health.

PMID:
31162084
DOI:
10.1016/S0140-6736(19)30954-7
[Indexed for MEDLINE]
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