Prevention of noncommunicable diseases by interventions in the preconception period: A FIGO position paper for action by healthcare practitioners

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.

Predictors of Women’s awareness of common non-communicable diseases screening during preconception period in Manna District, Southwest Ethiopia: implication for wellness check-up

“…It has paramount importance to reduce NCDs by providing an opportunity to early optimizing the health of potential mothers and couples [ 31 , 32 ]. The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and International Federation of Gynecology and Obstetrics (FIGO) recommends the need for women to screen for NCDs before conception which helps for early identification of the diseases, management, and reducing its consequences [ 31 , 33 , 34 ]. There are also evidences of the effectiveness of preconception care.…”

“…For instance, a systematic review and meta-analysis from Pakistan indicated that maternal diabetic care during preconception period reduces the occurrence of congenital malformations by 70% and perinatal mortality by 69% [ 35 ]. However, despite its importance and recommendations [ 31 , 33 , 34 ], to the best of the authors’ knowledge, there are no published articles on awareness of NCDs screening during the preconception period in Ethiopia. Therefore, this study aimed to assess women’s awareness of common NCDs screening during the preconception period and associated factors in Manna district, Jimma Zone, Oromia region, Ethiopia, 2019.…”

Prevention of Gestational Diabetes: The Role of Dietary Intake, Physical Activity, and Weight before, during, and between Pregnancies

“…Resources, such as the FIGO Nutrition Checklist, are available to health care practitioners to identify and address nutrition and weight issues before and during pregnancy. 76,77 A preconception risk assessment by health care professionals may identify women with preexisting diabetes, and also identify women at risk of GDM. 78 Risk assessment tools have shown nulliparous women at risk of GDM may be accurately identified before pregnancy based on a set of easily obtainable lifestyle and health-related characteristics 79,80 ; however, further research is needed to determine if preconception risk identification is acceptable and if model implementation followed by targeted preconception care reduces rates of GDM.…”

“…81,82 In addition to provision of preconception care among women planning for pregnancy, a universal approach of discussing dietary habits, risks of obesity, and potential benefits of weight loss prior to pregnancy at every contact with a healthcare practitioner is recommended. 77…”

“…2. [119][120][121] Additional specific guidance is available for women intending to become pregnant 77,[122][123][124][125][126] or pregnant (►Fig. 2).…”