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.
Bibliographical noteFunding Information:
CV holds a non-financial partnership with a UK supermarket chain to conduct an independent scientific evaluation of in-store interventions. Her work is funded by grants from government and charities and no financial benefits from the supermarket have been provided. SdeL is Director of the Royal College of General Practitioners Research Surveillance Centre; data from this network have been used for a range of commercial funded investigator led research; all uses of these data are available online or on request. None overlap with this study. LP is a member of Public Health England Scientific Advisory Committee on Nutrition; sub committee for Maternal and Child Nutrition. JC is a director of Dietary Assessment Ltd. KG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products, and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec and Danone . GC acknowledges support through H2020 grant no. 633595 DynaHEALTH. She has also received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No. 819752 DEVORHBIOSHIP). All other authors declare no competing interests.
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