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 Diaz Yamal, Jaideep Malhotra, Edgar Mocanu, H David McIntyre, Anne B Kihara, Ronald C Ma, Hema Divakar, Anil Kapur, Rui Ferriani, Ernest Ng, Laurie Henry, Zephne Van Der Spuy, Zev Rosenwaks, Mark A Hanson

Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2020;151 Suppl 1(Suppl 1):6-15

PMID: 32894587

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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.

Address: Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK.; UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.; Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.; Mor Comprehensive Women's Health Care Center, Tel Aviv, Israel.; FIGO Pregnancy and Non-Communicable Diseases Committee, International Federation of Gynecology and Obstetrics, London, UK.; Faculty of Medicine, University Militar Nueva Granada, Bogota, Colombia.; Fertility Center Procreation Medicamente Asistida, Bogota, Colombia.; FIGO Committee for Reproductive Medicine, Endocrinology, and Infertility, International Federation of Gynecology and Obstetrics, London, UK.; Malhotra Nursing and Maternity Home, Agra, India.; Rainbow Hospital, Agra, India.; RCSI Department of Reproductive Medicine, Rotunda Hospital, Dublin, Ireland.; Mater Research, The University of Queensland, South Brisbane, Qld, Australia.; African Federation of Obstetricians and Gynaecologists, Khartoum, Sudan.; Department of Obstetrics and Gynecology, School of Medicine, University of Nairobi, Nairobi, Kenya.; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong SAR, China.; Divakar's Specialty Hospital, Bengaluru, India.; World Diabetes Foundation, Bagsvaerd, Denmark.; Ribeirão Preto Medical School, Human Reproduction Sector, Department of Gynecology and Obstetrics, University of São Paulo, São Paulo, Brazil.; Department of Obstetrics and Gynecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China.; Department of Gynecology and Obstetrics, Centre de Procréation Médicalement Assistée (CPMA), University of Liège, CHR de la Citadelle, Liège, Belgium.; Department of Obstetrics and Gynecology, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa.; The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA.

DOI: 10.1002/ijgo.13331

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MeSH Terms: Body Weight, Female, Humans, Infant Health, Infant, Newborn, Maternal-Child Health Services, Noncommunicable Diseases, Practice Guidelines as Topic, Preconception Care, Pregnancy, Women's Health