Preconception

Kirsten I. Black, MBBS, MMed, FRANZCOG, PhD, FFSRH, DDU

Jacqueline Boyle, MBBS, FRANZCOG, MPH & TM, PhD

The preconception period is being recognized as a vital time to improve an individual's health and to benefit the health of future children enhancement of preconception health can be achieved though better pregnancy and reproductive life planning, improvements in awareness and education around preconception health for people in the community and in the development of guidelines, resources, and tools for healthcare practitioners. Underpinning preconception health is a broad socio-ecological model of health that incorporates health across the life course, policy, family, community, work, healthcare systems and practitioners and individual knowledge and behaviors. Importantly, understanding that there are existing disparities in health outcomes across the life-course and in pregnancy for groups that experience systemic disadvantage, we recognize the importance of an equity lens.

In this issue, we discuss existing clinical guidelines for preconception care through a systematic review of guidelines in Australia and New Zealand, the United Kingdom, United States of America, and Canada and identify strengths and gaps in current documents. We describe the relationship between women and men's modifiable preconception risks and the health outcomes of their children identifying the key areas of body composition, lifestyle, nutrition, environmental factors, and birth spacing. We examine inter-conception health as a key opportunity to engage with women accessing healthcare for their children to support them planning for a future pregnancy or to advise on contraception if pregnancy is not desired. School-based sexual and reproductive health education is examined as a key opportunity to provide preconception health education and to encourage young people's self-efficacy, as they transition to adulthood. Health economics informs health systems and policy and is examined here with a systematic review that reports that little evidence for the cost-effectiveness of preconception interventions exists and there is even less that examines aspects of equity. Finally, a national preconception network in Australia undertook a priority setting exercise in preconception healthcare reports on their top ten priorities, the underlying principles to guide them and key activities to help address the priorities. The articles in this issue target some of the gaps in the literature around preconception health in a socioecological approach in the hope of broadening the discussion around preconception health, the importance of improving equity in health outcomes and guidance for health practitioners in individual clinical care, but also those who work in health promotion, systems, and policy.

Publication History

Article published online:
28 July 2022