Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Pregnancy Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications.

Briony Hill,Heidi J Bergmeier,Hildrun Sundseth,Helen Skouteris,Leanne M Redman,Judith Stephenson,Brian Jack,Shakila Thangaratinam,Jacqueline A Boyle,Helena J Teede,Siew Lim,Eric Steegers,Cynthia Montanaro,Cate Bailey,Ruth Walker,Jo-Anna B Baxter,Ana Luiza Vilela Borges,Cheryce L Harrison,Laura Jorgensen

doi:10.3390/jcm9030822

Abstract

In this article, we describe the process of establishing agreed international pregnancy research priorities to address the global issues of unhealthy lifestyles and rising maternal obesity. We focus specifically on the prevention of maternal obesity to improve related clinical pregnancy and long-term complications. A team of multidisciplinary, international experts in preconception and pregnancy health, including consumers, were invited to form the Health in Preconception, Pregnancy and Postpartum (HiPPP) Global Alliance. As an initial activity, a priority setting process was completed to generate pregnancy research priorities in this field. Research, practice and policy gaps were identified and enhanced through expert and consumer consultation, followed by a modified Delphi process and Nominal Group Technique, including an international workshop. Research priorities identified included optimising: (1) healthy diet and nutrition; (2) gestational weight management; (3) screening for and managing pregnancy complications and pre-existing conditions; (4) physical activity; (5) mental health; and (6) postpartum (including intrapartum) care. Given extensive past research in many of these areas, research priorities here recognised the need to advance pregnancy research towards pragmatic implementation research. This work has set the agenda for large-scale, collaborative, multidisciplinary, implementation research to address the major public health and clinical issue of maternal obesity prevention.

Highlights

In developed nations, approximately 50% of women enter pregnancy above the healthy recommended weight [1,2,3]
Experts who contributed to the priority setting process included individuals from diverse disciplines, including endocrinology, psychology, obstetrics, gynaecology, exercise physiology, dietetics, health economics, epidemiology, nursing, public health, as well as two experts in consumer advocacy and consumer experience
International research priorities in pregnancy, for the prevention of maternal obesity and related pregnancy and long-term complications were identified by the multidisciplinary HiPPP Global Alliance experts through a multistep, transparent, modified Delphi and Nominal Group Technique consensus development process

Summary

Introduction

Approximately 50% of women enter pregnancy above the healthy recommended weight [1,2,3]. Pregnancy is a key driver of obesity in women [5,6]. Factors such as high preconception body mass index (BMI), excessive gestational weight gain and postpartum weight retention contribute independently and significantly to adverse maternal outcomes [7,8] and are associated with adverse health outcomes in offspring [9,10]. Identification of key pregnancy research priorities for the prevention of maternal obesity and related pregnancy and long-term complications is important to advance the field and generate international guidelines and policy directives that will inform practice and deliver public health impact

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Discussion

Conclusion