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Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health

Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health
Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health
A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from high, low and middle income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours.

Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high and lower income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents.

Numerous studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little impact on maternal and newborn health outcomes. There have been comparatively few attempts at preconception diet and lifestyle intervention. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that this is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception.

We propose novel definitions of the preconception period relating to embryo development and to action at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable disease. Alongside continued efforts to reduce smoking, alcohol and obesity in the population, we call for heightened awareness of preconception health, particularly regarding diet and nutrition. Importantly health professionals should be alerted to ways of identifying women who are planning a pregnancy.
0140-6736
Stephenson, Judith
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Heselhurst, N.
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Hall, Jennifer
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Schoenaker, Danielle A.J.M.
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Hutchinson, Jayne
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Cade, Janet
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Poston, Lucilla
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Barrett, Geraldine
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Crozier, Sarah
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Kumaran, Kalyanaraman
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Yanjik, C.
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Barker, Mary
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Baird, Janis
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Mishra, Gita
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Stephenson, Judith
b115169f-d010-4c24-8654-222613c3ed5c
Heselhurst, N.
a187b1b4-ded5-4811-8e04-af4fef5c7868
Hall, Jennifer
5840232e-82ab-45d6-af3c-e0b8ffe0bcd6
Schoenaker, Danielle A.J.M.
796b3cf0-4439-4457-ab25-1e5222f8564e
Hutchinson, Jayne
7548ea10-3c97-4f45-ba05-16645eb097e7
Cade, Janet
00e4216f-a895-4f13-996a-593a5c597e69
Poston, Lucilla
916aced2-462e-445f-9efa-83ed4b7b3a9f
Barrett, Geraldine
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Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Kumaran, Kalyanaraman
de6f872c-7339-4a52-be84-e3bbae707744
Yanjik, C.
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Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Baird, Janis
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Mishra, Gita
953a2060-b5f3-497f-a405-b1a2854ce0c7

Stephenson, Judith, Heselhurst, N., Hall, Jennifer, Schoenaker, Danielle A.J.M., Hutchinson, Jayne, Cade, Janet, Poston, Lucilla, Barrett, Geraldine, Crozier, Sarah, Kumaran, Kalyanaraman, Yanjik, C., Barker, Mary, Baird, Janis and Mishra, Gita (2018) Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health. The Lancet. (doi:10.1016/S0140-6736(18)30311-8).

Record type: Article

Abstract

A woman who is healthy at the time of conception is more likely to have a successful pregnancy and a healthy child. We reviewed published evidence and present new data from high, low and middle income countries on the timing and importance of preconception health for subsequent maternal and child health. We describe the extent to which pregnancy is planned, and whether planning is linked to preconception health behaviours.

Observational studies show strong links between health before pregnancy and maternal and child health outcomes, with consequences that can extend across generations, but awareness of these links is not widespread. Poor nutrition and obesity are rife among women of reproductive age, and differences between high and lower income countries have become less distinct, with typical diets falling far short of nutritional recommendations in both settings and especially among adolescents.

Numerous studies show that micronutrient supplementation starting in pregnancy can correct important maternal nutrient deficiencies, but effects on child health outcomes are disappointing. Other interventions to improve diet during pregnancy have had little impact on maternal and newborn health outcomes. There have been comparatively few attempts at preconception diet and lifestyle intervention. Improvements in the measurement of pregnancy planning have quantified the degree of pregnancy planning and suggest that this is more common than previously recognised. Planning for pregnancy is associated with a mixed pattern of health behaviours before conception.

We propose novel definitions of the preconception period relating to embryo development and to action at individual or population level. A sharper focus on intervention before conception is needed to improve maternal and child health and reduce the growing burden of non-communicable disease. Alongside continued efforts to reduce smoking, alcohol and obesity in the population, we call for heightened awareness of preconception health, particularly regarding diet and nutrition. Importantly health professionals should be alerted to ways of identifying women who are planning a pregnancy.

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Lancet Paper 1 Revised 250118 (002) Stephenson - Accepted Manuscript
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Accepted/In Press date: 1 February 2018
e-pub ahead of print date: 16 April 2018

Identifiers

Local EPrints ID: 419694
URI: https://eprints.soton.ac.uk/id/eprint/419694
ISSN: 0140-6736
PURE UUID: 9842f401-186c-454a-b4e5-5c8f69b249e6
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for Janis Baird: ORCID iD orcid.org/0000-0002-4039-4361

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Date deposited: 19 Apr 2018 16:30
Last modified: 10 Dec 2019 05:27

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Contributors

Author: Judith Stephenson
Author: N. Heselhurst
Author: Jennifer Hall
Author: Danielle A.J.M. Schoenaker
Author: Jayne Hutchinson
Author: Janet Cade
Author: Lucilla Poston
Author: Geraldine Barrett
Author: Sarah Crozier ORCID iD
Author: C. Yanjik
Author: Mary Barker ORCID iD
Author: Janis Baird ORCID iD
Author: Gita Mishra

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