Abstract
BackgroundThe health of a woman before conception not only influences the outcome of her pregnancy but also the lifelong health of mother and child. Many women in the UK are inadequately prepared for pregnancy, with reports of a high prevalence of smoking, low folic acid supplement use, and suboptimal diet and physical activity. Get Ready! will link an online digital tool to identify women planning pregnancy most at risk of complications with a personalised intervention to improve health behaviours and biomarkers of metabolic health.MethodsWomen planning pregnancy will be identified from a free and widely used online preconception tool. A short online screening questionnaire will then be used to recruit women considered to be at high metabolic risk. Eligibility criteria include resident in the UK, age > 18–< 50 years, BMI ≥ 23 kg/m2 (South Asian) or ≥ 25 kg/m2 (all other ethnicities), and plus one or more of the following: 1st degree relative with type 2 diabetes, previous gestational diabetes (GDM), previous baby > 4 kg, or high risk ethnicity for GDM. Eligible women who consent to participate will be enrolled in a commercially available preconception intervention (Prepare Plans, LiveSmart UK Ltd). Following an online health assessment and home blood test, women will be provided with individualised lifestyle advice and coaching by dietitians. Process evaluation will provide an assessment of implementation of the intervention. Change in health behaviours and biomarkers of metabolic health will also be examined.DiscussionSuboptimal health behaviours amongst women planning pregnancy are widely prevalent in the UK. Personalised health checks and coaching are especially important for women at risk of pregnancy complications. Get Ready! introduces a novel approach to identifying high risk women planning pregnancy and provision of a targeted intervention.RegistrationTrial sponsor: King’s College London.
Highlights
The health of a woman before conception influences the outcome of her pregnancy and the lifelong health of mother and child
Over half of women in the United Kingdom (UK) were overweight or obese in 2016–2017 [2], which increases the risk of adverse maternal, infant, and childhood outcomes and is a major burden to National Health Service (NHS) antenatal services and cost resources [3, 4]
The health of the mother before conception can profoundly influence the risk of complications in pregnancy and may adversely affect the lifelong health of the child [17]
Summary
The health of a woman before conception influences the outcome of her pregnancy and the lifelong health of mother and child. Health behaviours before pregnancy may profoundly influence pregnancy outcomes, and the future health of both mother and child, as detailed in a recent Lancet series [1]. The increasing awareness of health in the preconception period has been precipitated, at least in part, by the high prevalence of obesity amongst women at their first antenatal visit. Over half of women in the United Kingdom (UK) were overweight or obese in 2016–2017 [2], which increases the risk of adverse maternal, infant, and childhood outcomes and is a major burden to National Health Service (NHS) antenatal services and cost resources [3, 4].
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