• Judith Stephenson, Christina Vogel, Jennifer Hall, Jayne Hutchinson, Sue Mann, Helen Duncan, Kathryn Woods-Townsend, Simon de Lusignan, Lucilla Poston, Janet Cade, Keith Godfrey, Mark Hanson, Geraldine Barrett, Mary Barker, Gabriella Conti, Geordan Shannon, Tim Colbourn, and Preconception Partnership.
• Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK. Electronic address: judith.stephenson@ucl.ac.uk.
• Lancet. 2019 Jun 1; 393 (10187): 2262-2271.

AbstractThere is growing interest in preconception health as a crucial period for influencing not only pregnancy outcomes, but also future maternal and child health, and prevention of long-term medical conditions. Successive national and international policy documents emphasise the need to improve preconception health, but resources and action have not followed through with these goals. We argue for a dual intervention strategy at both the public health level (eg, by improving the food environment) and at the individual level (eg, by better identification of those planning a pregnancy who would benefit from support to optimise health before conception) in order to raise awareness of preconception health and to normalise the notion of planning and preparing for pregnancy. Existing strategies that target common risks factors, such as obesity and smoking, should recognise the preconception period as one that offers special opportunity for intervention, based on evidence from life-course epidemiology, developmental (embryo) programming around the time of conception, and maternal motivation. To describe and monitor preconception health in England, we propose an annual report card using metrics from multiple routine data sources. Such a report card should serve to hold governments and other relevant agencies to account for delivering interventions to improve preconception health.Copyright © 2019 Elsevier Ltd. All rights reserved.

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