News | The Lancet publishes preconception health monitoring framework, filling a global gap



News | The Lancet publishes preconception health monitoring framework, filling a global gap


A new study published in The Lancet proposes the first global set of indicators for monitoring preconception health, marking a step toward more systematic and standardized management. Conducted jointly by University College London and the University of Southampton, the study combines expert and public input to create a more comprehensive assessment framework.


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Growing attention to preconception health

As more women enter pregnancy with underlying conditions such as obesity, diabetes, and mental health problems, the effect of preconception health on pregnancy outcomes is receiving greater attention.


These conditions may increase the risk of pregnancy and childbirth complications, making systematic assessment and intervention before pregnancy an important public health issue.


First globally applicable indicator set

The team proposed a broad list of preconception health indicators for monitoring the health of reproductive-age populations worldwide, including both men and women.


Unlike previous indicator sets developed mainly from healthcare professionals’ perspectives, the new framework includes public input, making it more relevant and practical.


The team previously assessed preconception health using existing monitoring data from England, including smoking rates and folic acid supplementation before pregnancy, and published a report in 2022.


Survey covers more than 5,000 people in 13 countries

For the new study, researchers surveyed more than 5,000 people in 13 countries, including Australia, Brazil, and Ghana, about the health and social factors they considered most important before pregnancy.


Responses were highly consistent across countries and genders, with the following main priorities:


Mental health


Physical health


Supportive relationships


Financial circumstances


Researchers believe these factors should be central to future preconception health monitoring to provide a more complete picture of individual health.


More than 120 indicators narrowed to about 40 core measures

The team initially identified more than 120 potential indicators, too many for routine monitoring, and systematically reduced them to about 40 core measures.


Corresponding author Professor Judith Stephenson of the UCL Institute for Women’s Health said the indicators reflect both professional judgment and public understanding of preconception health, providing a more complete perspective.


She said the work is continuing toward an internationally agreed core indicator set that enables comparisons between countries.


Supporting global health monitoring and policy

The team plans to refine the indicators with researchers, clinicians, policymakers, and public representatives at an international workshop in Geneva.


Researchers will then call on the World Health Organization, the UK National Health Service (NHS), and national health monitoring agencies elsewhere to integrate the indicators into existing systems for continuous global monitoring of preconception health.


A unified monitoring system could help assess national health policies and interventions and guide future resource allocation.


Potential to improve pregnancy outcomes and intergenerational health

Growing evidence indicates that optimizing health before and between pregnancies can improve pregnancy and birth outcomes and may reduce chronic disease risk and intergenerational health inequalities.


However, without systematic monitoring tools, governments and health systems struggle to evaluate the real-world effects of relevant policies.


First author Dr. Danielle Schoenaker of the University of Southampton said a scientific indicator set would help guide preconception healthcare and resource allocation, improving the overall health of future families.


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