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Cited by 279Maternal and Neonatal HealthcarePublic Health and NutritionGlobal Maternal and Child Health

Preconception care: nutritional risks and interventions

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Dean, Sohni V, Lassi, Zohra S, Imam, Ayesha M, Bhutta, Zulfiqar A·2014·Reproductive Health
DOI 10.1186/1742-4755-11-s3-s3PMC PMC4196560
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Abstract

INTRODUCTION: There is increasingly a double burden of under-nutrition and obesity in women of reproductive age. Preconception underweight or overweight, short stature and micronutrient deficiencies all contribute to excess maternal and fetal complications during pregnancy. METHODS: A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on maternal, newborn and child health (MNCH) outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. RESULTS: Maternal pre-pregnancy weight is a significant factor in the preconception period with underweight contributing to a 32% higher risk of preterm birth, and obesity more than doubling the risk for preeclampsia, gestational diabetes. Overweight women are more likely to undergo a Cesarean delivery, and their newborns have higher chances of being born with a neural tube or congenital heart defect. Among nutrition-specific interventions, preconception folic acid supplementation has the strongest evidence of effect, preventing 69% of recurrent neural tube defects. Multiple micronutrient supplementation shows promise to reduce the rates of congenital anomalies and risk of preeclampsia. Although over 40% of women worldwide are anemic in the preconception period, only one study has shown a risk for low birth weight. CONCLUSION: All women, but especially those who become pregnant in adolescence or have closely-spaced pregnancies (inter-pregnancy interval less than six months), require nutritional assessment and appropriate intervention in the preconception period with an emphasis on optimizing maternal body mass index and micronutrient reserves. Increasing coverage of nutrition-specific and nutrition-sensitive strategies (such as food fortification; integration of nutrition initiatives with other maternal and child health interventions; and community based platforms) is necessary among adolescent girls and women of reproductive age. The effectiveness of interventions will need to be simultaneously monitored, and form the basis for the development of improved delivery strategies and new nutritional interventions.

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  • Lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception.

    “Evidence suggests that lifestyle changes, such as reducing alcohol use and smoking, losing weight, improving fruit and vegetable consumption, can reduce the prevalence of adverse pregnancy outcomes, especially when initiated in early pregnancy or even before conception [4–7].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [6]

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  • An unhealthy diet, lifestyle behaviours and exercising pattern are progressively becoming part of Western society, including among a high percentage of women in their reproductive age.

    “Our results are relevant since an unhealthy diet, lifestyle behaviours and exercising pattern are progressively becoming part of Western society, including among a high percentage of women in their reproductive age [5, 6, 16].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [6]

    The Diet, exercise and weight loss section (page not supplied) identifies poor-quality diets and physical inactivity as concerns that disproportionately affect mothers and young children. The Discussion describes maternal overweight and obesity as a growing problem worldwide. The paper does not establish that these behaviours are becoming more common specifically in Western society or quantify a high percentage of women of reproductive age engaging in them. (LLM, conf=0.84)

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Authors
Dean, S. V., Lassi, Z. S., Imam, A. M., & Bhutta, Z. A.
Affiliations
Aga Khan University (PK)
Corresponding author
Bhutta, Zulfiqar A
ORCID
Venue
Reproductive Health
Publisher
Springer Science and Business Media LLC
Published
2014-09-26
Volume
11
Issue
S3
Pages
S3-S3
ISSN
1742-4755 (ISSN-L)
DOI
10.1186/1742-4755-11-s3-s3
PMC
PMC4196560
OpenAlex
W2126430455
Cited by
279
References
14
Citations by year
2026: 6 · 2025: 17 · 2024: 25 · 2023: 60 · 2022: 26 · 2021: 32 · 2020: 29 · 2019: 14 · 2018: 17 · 2017: 22 · 2016: 15 · 2015: 12 · 2014: 4
FWCI
3.01
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Reproductive Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
Topics
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Public Health and Nutrition
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
preconception care, maternal nutrition, pre-pregnancy weight, underweight, overweight, obesity, adolescent pregnancy, multiple micronutrient supplementation, folic acid supplementation, neural tube defects, preeclampsia, gestational diabetes mellitus, anemia, low birth weight, congenital malformations, interpregnancy interval, food fortification, maternal and child health
MeSH terms
Congenital Abnormalities, Body Weight, Female, Folic Acid, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Preconception Care, Dietary Supplements, Prenatal Nutritional Physiological Phenomena

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