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. 2023 Sep;130(10):1187-1195.
doi: 10.1111/1471-0528.17436. Epub 2023 Mar 21.

Women's preconception health in England: a report card based on cross-sectional analysis of national maternity services data from 2018/2019

Danielle A J M Schoenaker  1   2   3 , Judith Stephenson  4 , Helen Smith  3 , Kate Thurland  3 , Helen Duncan  3 , Keith M Godfrey  2   5 , Mary Barker  5   6 , Claire Singh  7 , Nisreen A Alwan  1   2   8 ; UK Preconception Partnership
Affiliations

Women's preconception health in England: a report card based on cross-sectional analysis of national maternity services data from 2018/2019

Danielle A J M Schoenaker et al. BJOG. 2023 Sep.

Abstract

Objective: To present the first national-level report card on the state of women's preconception health in England.

Design: Cross-sectional population-based study.

Setting: Maternity services, England.

Population: All pregnant women in England with a first antenatal (booking) appointment recorded in the national Maternity Services Dataset (MSDS) from April 2018 to March 2019 (n = 652 880).

Methods: We analysed the prevalence of 32 preconception indicator measures in the overall population and across socio-demographic subgroups. Ten of these indicators were prioritised for ongoing surveillance based on modifiability, prevalence, data quality and ranking by multidisciplinary UK experts.

Results: The three most prevalent indicators were the proportion of the 22.9% of women who smoked 1 year before pregnancy who did not quit smoking before pregnancy (85.0%), those who had not taken folic acid supplementation before pregnancy (72.7%) and previous pregnancy loss (38.9%). Inequalities were observed by age, ethnicity and area-based deprivation level. The ten indicators prioritised were not taking folic acid supplementation before pregnancy, obesity, complex social factors, living in the most deprived areas, smoking around the time of conception, overweight, pre-existing mental health condition, pre-existing physical health condition, previous pregnancy loss and previous obstetric complication.

Conclusions: Our findings suggest important opportunities to improve the state of preconception health and reduce socio-demographic inequalities for women in England. In addition to MSDS data, other national data sources that record further and possibly better quality indicators could be explored and linked to build a comprehensive surveillance infrastructure.

Keywords: preconception health; routine health data; surveillance.

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Conflict of interest statement

KMG has received reimbursement for speaking at conferences sponsored by companies selling nutritional products, and is part of an academic consortium that has received research funding from Abbott Nutrition, Nestec, BenevolentAI Bio Ltd. and Danone. The other authors have no conflicts of interest to disclose. Completed disclosure of interests forms are available to view online as supporting information.

Figures

FIGURE 1
FIGURE 1
Prevalence of preconception indicator domains among pregnant women in England. The size of each area and the size of their overlap are an approximation and do not accurately reflect the percentages. Domains: wider determinants of health (indicators: ethnic minority, unemployed and seeking work, living in the most deprived areas, complex social factors and/or English not the first language); reproductive health (indicators: advanced maternal age, teenage pregnancy, previous obstetric complication and/or previous pregnancy loss); health behaviours and weight (indicators: not taking folic acid supplementation before pregnancy, smoking around the time of conception, not quitting smoking during year before pregnancy, underweight, overweight and/or obesity); health conditions (indicators: pre‐existing mental health condition and/or pre‐existing physical health condition); family history (indicators: family history of inherited condition and/or family history of diabetes).
See this image and copyright information in PMC

Comment in

References

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