Prevention of noncommunicable diseases by interventions in the preconception period: A FIGO position paper for action by healthcare practitioners
Chandni Maria Jacob, Sarah Louise Killeen, Fionnuala M. McAuliffe, Judith Stephenson, Moshe Hod, Ivonne Díaz Yamal, Jaideep Malhotra, Edgar Mocanu, David McIntyre, Anne‐Beatrice Kihara, Ronald C.W., Hema Divakar, Anil Kapur, Rui Alberto Ferriani, Ernest Hung Yu Ng, Laurie Henry, Zephne M. van der Spuy, Zev Rosenwaks, Mark A. Hanson
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.