New report card could mark governments' progress in improving preconception health
Researchers, including a group from the University of Southampton, say action for healthier pregnancies and babies means increasing intake of vitamins, being free of smoking and alcohol and keeping to a healthy diet and weight before conception. A team of clinicians and researchers have developed a new way to scrutinize the state of the nation's health before pregnancy and hold public bodies to account for delivering improvements.
FAB RESEARCH COMMENT:
It has been known for a long time that 'early life' is a critical period in which environmental influences - and particularly nutrition - have permanent effects on the health and development of any individual; and that many health disorders that manifest only in later life (including heart disease, diabetes and even dementia) actually have their origins in factors that operate before a child is even born.That critical 'early life' period is often taken to mean pregnancy and early infancy - as 'the first 1000 days' from conception undoubtedly represent a unique period, involving the extraordinarily rapid formation, growth and development of the whole body and brain.
During pregnancy, the nutrition and health of the mother are critical influences - as her diet and nutrient stores must provide (via placental transfer), everything that the embryo and foetus need for successful development until birth. Similarly, her metabolic and immune health, and exposure to any environmental toxins and other stressors can also permanently shape the development of the unborn child.
However, the lifelong influences on health and wellbeing actually start even earlier - because maternal (and paternal) health in the period before conception even takes place are equally important to the lifelong health, development and wellbeing of any child.
Preconception health therefore matters greatly - in the same way that the survival and successful growth to maturity of the seed from a plant will depend on the quality and 'fertility' of the soil into which it is first implanted, as well as the conditions to which it is subsequently exposed.
This new research not only summarises several key 'diet and lifestyle' factors that could improve the health of mothers-to-be (and fathers-to-be), but also makes several very sensible proposals for monitoring the effectiveness of public health policies to improve preconception health - both at the population level (which is very important, because around 50% of pregnancies are unplanned) and for those individuals who actively plan for their pregnancy.
For details of the underlying research, see:
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10 June 2019 - MedicalXpress
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Researchers, including a group from the University of Southampton, say action for healthier pregnancies and babies means increasing intake of vitamins, being free of smoking and alcohol and keeping to a healthy diet and weight before conception.
A team of clinicians and researchers have developed a new way to scrutinize the state of the nation's health before pregnancy and hold public bodies to account for delivering improvements.
Policy makers have shown increasing interest in how improving preconception health can provide better pregnancy outcomes as well as future maternal and child health. However there is still a lack of action and resources in order to deliver this.
In a new paper, published in The Lancet, the Preconception Partnership advises that the preconception period needs to become a focus of existing strategies that tackle obesity, smoking, nutrition, alcohol, maternal and child health, reproductive health, and non-communicable diseases.
The report card they are proposing sets out a number of interventions that can improve preconception health at a population level, irrespective of pregnancy planning, and at an individual level for those who plan to become pregnant.
At the individual level, the researchers believe that in healthcare, asking young people and adults whether they are considering trying for a baby should become the new normal—with the goal of healthier children and healthier parents through greater awareness, planning and preparation for pregnancy.
At a population level, interventions include improving the food environment through fortification of flour with folic acid to prevent neural tube defects (spina bifida), fiscal measures on unhealthy foods and regulation around fast food outlets.
The researchers also believe that the school curriculum could include the simple message that health is something to consider before, rather than after, becoming pregnant.
Professor Mary Barker of the University of Southampton who co-chairs the Preconception Partnership said: "If we wish to improve preconception health, we need to monitor our progress. Our new paper in The Lancet proposes an annual 'report card' on the state of the nation's preconception health. We suggest a range of measures at both public health and individual levels."
Lead author of the report, Professor Judith Stephenson of University College London said: "as the quality of maternity care in this country has improved hugely over the years, the relative neglect of women's health before conception and between pregnancies has become more stark. It is time for the 'book-ends of pregnancy' to have more of our attention and resources."
Co-Author Keith Godfrey, Professor of Epidemiology & Human Development at the University of Southampton said:
"Planning & preparing for pregnancy is crucial to the health of the next generation of babies & children. Our new article proposes a report card, to hold governments & relevant agencies to account for delivering interventions to improve preconception health.
"Public Health England have recently produced a suite of resources making the case for a focus on preconception care, and the report card seeks to build on this to deliver lasting benefits for mothers and their children and to prevent long-term conditions in later life."
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