Preconception health in adolescence and adulthood across generations in the UK: findings from three British birth cohort studies

Abstract

Optimising preconception health in women and men holds significant potential for improving pregnancy and offspring health outcomes. To create a picture of the state of preconception health in the UK, this study aimed to describe the prevalence of and changes in preconception health indicators reported in three British birth cohort studies: the 1970 British Birth Cohort Study (BCS70; born in 1970; N=17,198), Next Steps (1989-1990; N=15,770), and Millennium Cohort Study (MCS; 2000-2002; N=19,517). The analysis focused on data obtained during participants’ adolescence (16-17 years) and subsequent follow-ups at 25-26 years for BCS70 and Next Steps. Self-reported preconception indicators were defined in line with a previously published review and reported as proportions.Across cohorts, data were available for 14 preconception indicators across four domains: health behaviours and weight, reproductive health and family planning, physical health conditions, and wider determinants of health. Findings revealed persistent suboptimal health behaviours in both genders and across generations, including low intakes of fruit. While alcohol, tobacco, and soft drink intake decreased across generations, obesity prevalence surged. This study underscores the need for public health interventions targeting the root causes of adverse health behaviours towards improvement of fruit consumption, further reduction in alcohol, tobacco, and soft drink consumption, and addressing the escalating obesity rates among individuals of reproductive age. Ongoing monitoring is needed to continue tracking these existing indicators over time, while improved data quality and availability of a wider range of preconception indicators are crucial to comprehensively understanding the complexities of preconception health, enabling the development of more targeted and effective interventions.

Tackling inequalities in preconception health and care: barriers, facilitators and recommendations for action from the 2023 UK Preconception EMCR Network conference

“…Based on the most recent data from the UK, about half of pregnancies are unplanned, 2 and nine in 10 women enter pregnancy with at least one potentially modifiable risk factor for pregnancy and birth complications, including smoking, obesity, and lack of folic acid supplement use. 3 These risk factors are common among both women and men across the reproductive years, 3,4 including those who are actively planning pregnancy. 5,6 Suboptimal pregnancy planning and preconception health disproportionality affect subgroups of the population.…”

What does ‘preconception health’ mean to people? A public consultation on awareness and use of language

“…2 For example, maternal folic acid supplement use reduces the risk of neural tube defects and anomaly-related terminations, 3 while maternal and paternal obesity are associated with increased risk of obesity and the associated longterm adverse health consequences in their children. 4,5 Preconception risk factors are common among women and men in the UK across their reproductive years, 6 including among those who are actively planning pregnancy, 7,8 and who become pregnant. 9 Large social and economic inequalities exist in pregnancy planning and preconception health, [9][10][11] and it is therefore important to apply structural changes to the systems with which people interact and provide appropriate support to enable people to be healthy.…”