Researchers from the University of Technology Sydney led by one of our very own academics at Endeavour College of Natural Health, Cherie Caut wanted to know what preconception risks and health behaviours are associated with maternal and offspring health outcomes. Cherie and her research team reviewed 27 systematic reviews or meta-analyses (known as an umbrella review) examining associations between modifiable preconception risks and health behaviours and maternal and offspring health outcomes (Caut et al., 2022).

The results identified evidence-based modifiable preconception risks and health behaviours across categories including body composition, lifestyle behaviours, nutrition, environmental exposures, and birth spacing that are important for women and men to be aware of before planning a pregnancy together and can impact the mother and her baby in a variety of ways (Caut et al., 2022).

Let’s take a closer look at what the research findings say.

Body composition

Being in a healthy weight range before pregnancy (i.e., not being underweight, overweight or obese for women, or overweight or obese for men) is important for both women and men.

Some of the outcomes found to be associated with body composition during preconception include a longer time to pregnancy, miscarriage, preterm birth, small for gestational age infants and low birth weight infants, maternal preeclampsia, maternal gestational diabetes mellitus, caesarean birth, large for gestational age infants, still birth, birth defects, neurodevelopmental outcomes in children and being overweight in childhood (Caut et al., 2022).

Lifestyle

Smoking, consuming alcohol, the level of caffeine consumed, and physical activity undertaken for women are important risks and health behaviours during preconception to be considered. Smoking and alcohol should be avoided in women and daily caffeine levels kept low (at least below 300mg/day), physical activity should be moderate while also avoiding vigorous activity. For women and men if there are illicit drugs being used there are also risks (Caut et al., 2022).

Some of the outcomes found to be associated with modifiable lifestyle factors during preconception include prolonged time to pregnancy, reduced embryonic growth trajectories, increased miscarriage risk, low birth rate, preterm birth, small for gestational age infant, congenital heart defects, and neural tube defects (Caut et al., 2022).

Nutrition

The type of dietary pattern (e.g., Mediterranean), supplementing with multivitamins and folic acid are important health behaviours for women to consider when planning their pregnancy (Caut et al., 2022).

Some of the outcomes found to be associated with nutrition health behaviours during preconception include lower odds of attending an infertility consultation, reduction in miscarriage risk, reduction in preeclampsia, reduction in risk for low birth weight, reduced risk of neural tube defects, reduction in small for gestational age and reduction in preterm birth (Caut et al., 2022).

Environmental

Checking their risk for exposure to ionising radiation, chemicals and metals are other important considerations for both women and men to have while planning a pregnancy (Caut et al., 2022).

Some of the outcomes found to be associated with environmental exposures during preconception include increased risk of miscarriage, childhood cancers, congenital heart defects, neural tube defects, low birthweight, reduced intrauterine growth, anencephaly, and acute lymphoblastic leukaemia (Caut et al., 2022).

Birth spacing

For women planning a subsequent pregnancy, thinking about the time between pregnancies is an important factor. The risks are greater when the interval in between each pregnancy is less than 24 months (Caut et al., 2022).

Some of the outcomes found to be associated with short interpregnancy interval include maternal obesity, preeclampsia, labour dystocia, precipitous labour, placental abruption, and uterine rupture in women attempting vaginal birth after a previous caesarean birth (Caut et al., 2022).

So, what does this really mean?

For women and/or couples wishing to start a family there are some modifiable preconception risks and health behaviours that should be considered before you begin trying to conceive. Discussing your individual preconception risks and what health behaviours might be relevant to you with your health care provider is one of the first steps you can take towards a healthier pregnancy and your child’s future health (Caut et al., 2022).

If you would like to view the full research findings as summarised in our blog our article is published in Seminars in Reproductive Medicine at https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0042-1744257

Are you starting your preconception journey? You might like to check out these blogs too:

• 6 steps to increasing fertility and supporting preconception
• Three naturopath-recommended supplements to help women fall pregnant
• Did you know these foods could help you conceive?

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References

Caut, C., Schoenaker, D., McIntyre, E., Vilcins, D., Gavine, A., & Steel, A. (2022). Relationships between Women's and Men's Modifiable Preconception Risks and Health Behaviors and Maternal and Offspring Health Outcomes: An Umbrella Review. Seminars in reproductive medicine, 40(3-04), 170–183. https://doi.org/10.1055/s-0042-1744257