Abstract
With the increase in obesity prevalence among women of reproductive age globally, the risks of type 2 diabetes, gestational diabetes, pre‐eclampsia, and other conditions are rising, with detrimental effects on maternal and newborn health. The period before pregnancy is increasingly recognized as crucial for addressing weight management and reducing malnutrition (both under‐ and overnutrition) in both parents to reduce the risk of noncommunicable diseases (NCDs) in the mother as well as the passage of risk to her offspring. Healthcare practitioners, including obstetricians, gynecologists, midwives, and general practitioners, have an important role to play in supporting women in planning a pregnancy and achieving healthy nutrition and weight before pregnancy. In this position paper, the FIGO Pregnancy Obesity and Nutrition Initiative provides an overview of the evidence for preconception clinical guidelines to reduce the risk of NCDs in mothers and their offspring. It encourages healthcare practitioners to initiate a dialogue on women’s health, nutrition, and weight management before conception. While acknowledging the fundamental importance of the wider social and environmental determinants of health, this paper focuses on a simple set of recommendations for clinical practice that can be used even in short consultations. The recommendations can be contextualized based on local cultural and dietary practices as part of a system‐wide public health approach to influence the wider determinants as well as individual factors influencing preconception health.
Highlights
Definitions of the preconception period vary from “3 months before conception”[1] to “a minimum of 1–2 years before the initiation of any unprotected sexual intercourse that could possibly result in a preg‐ nancy”.2 More recently, the Lancet series on preconception health called for a new definition that considers multiple perspectives: biological; individual; and public health.[1]Preconception care is defined as “a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and man‐ agement, emphasizing those factors that must be acted on before con‐ ception or early in pregnancy to have maximal impact”.3 This includes care provided regardless of pregnancy status or intention.[4]
Elements of preconception care can occur whenever a healthcare practitioner meets a woman of childbearing age and this would include offering support for pregnancy planning or contraception counselling, and addressing nutrition and weight management.[22,24,25]
This FIGO position paper summarizes key evidence and international guidelines from predominant areas of preconception health related to noncommunicable diseases (NCDs), nutrition, and obesity
Summary
Definitions of the preconception period vary from “3 months before conception”[1] to “a minimum of 1–2 years before the initiation of any unprotected sexual intercourse that could possibly result in a preg‐ nancy”.2 More recently, the Lancet series on preconception health called for a new definition that considers multiple perspectives: biological (days to weeks before embryo development); individual (weeks to months before pregnancy); and public health (months to years).[1]. Preconception care is defined as “a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through prevention and man‐ agement, emphasizing those factors that must be acted on before con‐ ception or early in pregnancy to have maximal impact”.3. This includes care provided regardless of pregnancy status or intention.[4] A limita‐ tion in delivering preconception care has been the focus on women and couples motivated to conceive. Elements of preconception care can occur whenever a healthcare practitioner meets a woman of childbearing age and this would include offering support for pregnancy planning or contraception counselling, and addressing nutrition and weight management.[22,24,25]
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Schedule a callMore From: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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