Preconceptional health: an investment in the future of children

The preconception health of women and men, and therefore of the couple, are fundamental for the future health of their children. On conceivecorner.com we have always emphasized the importance of being well prepared, especially from a physical point of view before becoming pregnant.

A very detailed analysis was published a few days ago in the scientific journal The Lancet which better defines the preconception period and the implications that this time window has on the health of the unborn child, in the short and long term.

Preconception health

The analysis published in The Lancet consists of three documents of fundamental importance for public health, obtained thanks to the collaboration of researchers from the University of London (UCL), the University of Southampton, the University of Queensland (Australia) and of the University of the Witwatersrand (Johannesburg).

The intent was to better define the pre-conception period , outline the way certain pre-conception risk factors affect the health of the unborn child in the short and long term and, finally, propose interventions to improve pre-conception health with information and targeted training.

One of the lead authors of the detailed analysis which looked at British and Australian women aged 18-42, is Professor Judith Stephenson (UCL Institute for Women’s Health) who said: “The pre-conception period is a critical time in where parental health (including weight, metabolism and diet) may influence the risk of future chronic disease in children: we therefore need to reassess public health policies to help reduce this risk.

The emphasis has always been on alcohol, smoking and drugs, but these are not the only risk factors that can undermine a child’s health. Future parents must also be informed about the implications that their diet and metabolism have on the well-being of the unborn child.

Adds Professor Stephenson: ‘It’s not about scaring or making people feel guilty – our analysis establishes the importance of preconception health, emphasizes social responsibility and requires strong local, national and international leadership.’

To help improve health for future generations, the authors call for a common focus, which is better guidance and support for people planning to become pregnant and increased public health measures to reduce obesity and improve nutrition.

What is the preconception period?

Until now, the preconception period was considered the three months before conception, since this is the average time needed for fertile couples to be able to get pregnant. However, this is an imprecise definition that does not take into account the time it takes to achieve improvements in preconception health: some take less than a month (for example, to reach an adequate folate concentration through supplements) and others take months or years (for example to reach an ideal weight).

For this reason, the preconception period has been redefined as follows:

• from a biological point of view: the days and weeks before and after conception;
• from an individual point of view: the weeks or months that pass from when the couple decides to have a baby, to the onset of pregnancy
• public health: as many months or years as needed to remove preconception risk factors, such as diet and obesity.

Risk factors for preconception health

Evidence suggests that smoking, alcohol and caffeine intake, diet, obesity and malnutrition potentially cause genetic, cellular, metabolic and physiological changes during the development of the unborn child. These are changes that have lasting consequences in adulthood and increase the risk of cardiovascular, metabolic, immune and neurological diseases throughout life.

In particular, maternal obesity , which is also linked to adverse pregnancy outcomes, is thought to increase levels of inflammation, hormone levels and metabolites, which can directly alter egg and embryo development, for increase the risk of chronic disease in old age. Male obesity is also important and is associated with poor sperm quality, quantity and motility, which could increase the risk of chronic disease in later life. However, it is unclear whether paternal diet and obesity have as strong an influence as maternal preconceptional health.

The authors also add that there may be more risk factors associated with health before conception that have not yet been identified.

The authors also calculated the percentage of women of reproductive age (18-42 years) in the UK who are nutritionally prepared for pregnancy. The results are not encouraging: it has been seen that many UK women are not nutritionally prepared for pregnancy and almost all women of reproductive age (96%) have intakes of iron and folic acid below the recommended dose for pregnancy. pregnancy (14.8 mg and 400 μg per day, respectively).

Based on these data, the authors request interventions that must necessarily start years before the pregnancy. They also underline the importance of improving the health of all, from an early age, with the widest possible action to improve the health of future generations.

How to improve preconception health?

Estimates from 2012 suggest that 40% of pregnancies are unplanned and therefore large-scale interventions are needed to improve nutrition and behavior at the general population level. Interventions that must be directed to young people, and in particular to adolescents. According to the authors, schools should help young adults prepare for future parenthood . Adolescents should understand how their diet affects their health, and the implications this may have on their future life but also on the health of the children they will have.

Greater support is also needed in all those planning a pregnancy.

The authors also suggest that the food industry and food retailers should be part of the solution, collaborating with governmental organizations, non-governmental organizations and research institutes to raise awareness of preconception health.

According to Dr Mary Barker, of the University of Southampton, UK, “Improving the general health of the population and raising awareness of the importance of the period before pregnancy could help improve the health of future generations ”. She adds: “It is everyone’s responsibility to support our young adults as successful parents of healthy, long-lived children. ”