Interventions to prevent maternal obesity before conception, during pregnancy, and post partum.

Mark Hanson, Mary Barker, Jodie M Dodd, Shiriki Kumanyika, Shane Norris, Eric Steegers, Judith Stephenson, Shakila Thangaratinam, Huixia Yang

Journal: The lancet. Diabetes & endocrinology 2018;5(1):65-76

PMID: 27743974

Full Text on Elsevier Science View on PubMed

Abstract

Prevention of obesity in women of reproductive age is widely recognised to be important both for their health and for that of their offspring. Weight-control interventions, including drug treatment, in pregnant women who are obese or overweight have not had sufficient impact on pregnancy and birth outcomes, which suggests that the focus for intervention should include preconception or post-partum periods. Further research is needed into the long-term effects of nutritional and lifestyle interventions before conception. To improve preconception health, an integrated approach, including pregnancy prevention, planning, and preparation is needed, involving more than the primary health-care sector and adopting an ecological approach to risk reduction that addresses personal, societal, and cultural influences. Raising awareness of the importance of good health in the period before pregnancy will require a new social movement: combining bottom-up mobilisation of individuals and communities with a top-down approach from policy initiatives. Interventions to reduce or prevent obesity before conception and during pregnancy could contribute substantially to achievement of the global Sustainable Development Goals, in terms of health, wellbeing, productivity, and equity in current and future generations.

Address: Institute of Developmental Sciences, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Electronic address: [email protected].; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.; Discipline of Obstetrics & Gynaecology and Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia; Women's and Babies Division, Women's and Children's Hospital, North Adelaide, SA, Australia.; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.; MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Department of Obstetrics & Gynaecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.; Department of Reproductive Health, Institute for Women's Health, University College London, London, UK; Children, Young People and Maternal Health Programme, UCL Partners Academic Health Science Partnership, London, UK.; Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.; Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.

DOI: 10.1016/S2213-8587(16)30108-5

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MeSH Terms: Early Medical Intervention, Female, Humans, Obesity, Postnatal Care, Preconception Care, Pregnancy, Pregnancy Complications, Risk Reduction Behavior