Global Pre-Pregnancy Health: Key Indicators Identified for Monitoring System | News-Medical.net

As more individuals embark on parenthood with pre-existing health conditions – including obesity, diabetes, and mental health concerns – attention is increasingly focused on the critical importance of pre-pregnancy health for both prospective mothers and fathers. Researchers at University College London and the University of Southampton have, for the first time, identified key health and social indicators needed for a new global system to monitor wellbeing before pregnancy. This work aims to improve pregnancy and birth outcomes, and reduce health inequalities across generations.

The findings, published in The Lancet, represent a significant step towards a more holistic understanding of factors influencing reproductive health. The research doesn’t just reflect the priorities of healthcare professionals; crucially, it incorporates the perspectives of the general public, gathered from over 5,000 people across 13 countries, including Australia, Brazil, and Ghana.

Beyond Clinical Measures: What Matters to Individuals

The study revealed a remarkable consistency in priorities across diverse populations. Participants consistently highlighted mental health, physical health, supportive relationships, and financial stability as being paramount before starting a family. These factors, researchers say, are essential components of any effective monitoring system. This broad view moves beyond traditional clinical indicators, acknowledging the complex interplay of social and emotional wellbeing in reproductive health.

Previously, the research team examined existing health indicators monitored in England, such as smoking rates and folic acid supplementation – known to reduce the risk of birth defects. This work informed a 2022 report by the Office for Health Improvement and Disparities in England on the state of the nation’s preconception health. The current, expanded research builds on this foundation by incorporating global perspectives.

A Collaborative Approach to Defining Core Indicators

The researchers initially identified over 120 relevant indicators, a number deemed too extensive for routine surveillance. Through a rigorous collaborative process, they narrowed this list down to approximately 40. Professor Judith Stephenson, Senior author from UCL EGA Institute for Women’s Health, explained that the goal is to prioritize a set of internationally agreed-upon core indicators. “Indicators relating to conception tend to be from a health professionals’ perspective – we have, for the first time, produced a set of agreed metrics which reflect the views of the general public,” she stated. “Together, these indicators will give us a more holistic view of health before people try to get pregnant.”

The next step involves an international workshop in Geneva, where researchers, clinicians, policymakers, and members of the public will collaborate to finalize the indicator list. The ultimate aim is to encourage the World Health Organization (WHO), the NHS, and other national health surveillance agencies to integrate these indicators into existing infrastructures, enabling global monitoring of pre-pregnancy health.

Why Pre-Pregnancy Health Matters: A Growing Body of Evidence

Dr. Danielle Schoenaker, lead author from the University of Southampton and the National Institute for Health and Care Research Southampton Biomedical Research Centre, emphasizes the growing evidence supporting the optimization of health before and between pregnancies. “There is growing evidence that supporting people to optimise health before and between pregnancies can improve pregnancy and birth outcomes and also reduce intergenerational inequalities and chronic disease risk,” she said. This isn’t simply about a healthy pregnancy; it’s about breaking cycles of disadvantage and improving long-term health for both parents and children.

Without robust monitoring systems, it’s tough for governments and health services to assess the effectiveness of their policies and programs. The identified metrics could also guide future investment in care and support, specifically targeting areas where health inequalities are most pronounced. This proactive approach could lead to significant improvements in health outcomes for future families.

The Challenge of Global Comparability

A key challenge lies in achieving consensus on core indicators that can be reliably compared across countries with varying levels of income and healthcare infrastructure. Professor Stephenson highlights the need for strong international collaboration to address this issue. “A strong international collaboration is now needed to achieve consensus on which core indicators can be compared across low-, middle- and high-income countries.”

This isn’t simply a matter of translating indicators; it’s about ensuring they are culturally relevant and feasible to measure in diverse settings. For example, a measure of “social support” might need to be adapted to reflect different cultural norms and community structures.

What’s Next: From Indicators to Actionable Insights

The development of these indicators is just the first step. The immediate next phase involves finalizing the list at the Geneva workshop and advocating for its adoption by key international and national health bodies. However, the long-term success of this initiative hinges on the ability to translate these indicators into actionable insights.

This will require not only data collection but also robust data analysis and interpretation. It will also necessitate a commitment to addressing the underlying social and economic determinants of health that contribute to pre-pregnancy health disparities. The WHO will likely play a central role in coordinating these efforts, providing technical assistance to countries, and promoting the sharing of best practices.

the goal is to create a system that empowers individuals, healthcare providers, and policymakers to work together to optimize health before pregnancy, leading to healthier families and a more equitable future. Further research will be needed to refine these indicators and assess their impact on pregnancy outcomes and long-term health.