Most UK women 'not nutritionally prepared for pregnancy' finds review

Wednesday April 18 2018

"British women are woefully unprepared for pregnancy because they're living unhealthy lifestyles, new research has found," reports the Metro. The coverage follows the publication of a series of reviews assessing the importance of nutrition prior to getting pregnant.

The reviews generally support our understanding that adequate nutrition through a balanced diet, and avoiding unhealthy behaviour like smoking, is the best preparation for pregnancy. Waiting until pregnancy to address a poor diet, while still beneficial, is too late to benefit fully.

The review estimated that most younger women in the UK are "not nutritionally prepared for pregnancy".

Don't assume men are off the hook, either. In a related review, the researchers discussed how obesity in men can also adversely affect a child's development.

Of course, not all pregnancies are planned. If you discover you're pregnant, there are immediate steps you can take to improve your health and reduce the risk of complications. These include: quitting smoking if you smoke, eating a healthy diet with at least 5 portions of vegetables or fruit, and avoiding alcohol.

What was the basis for the news reports?

The reports were prompted by a 3-part series of reviews on worldwide preconception health, published in The Lancet, a peer-reviewed medical journal.

Most of the press coverage focused on the first review, which looked at women's nutrition and lifestyle in the preconception period, and its importance for future health.

The other 2 reviews looked at parental factors around the time of conception that affect lifetime health, and what can be done at a public health level to improve preconception health.

What were the review's main messages?

For the first review, the key messages were that:

  • the health of both parents before conception is strongly linked to healthy pregnancies and children's long-term health
  • many women, not just those in low-income countries, have nutritional deficiencies before pregnancy
  • in many countries, around half of women are overweight or obese when they become pregnant
  • supplementation with folic acid for several weeks before conception is recommended

Folic acid supplementation helps prevent defects such as spina bifida, where the brain and spinal cord do not form properly. Folic acid is needed during the earliest stages of pregnancy, when the baby's spinal cord is forming – starting supplements once already pregnant is too late.

Other nutritional supplements targeted at women just before or during pregnancy have not demonstrated clear benefits for children. For example, iron and vitamin D deficiencies are fairly common but, while correcting these may respectively improve babies' blood haemoglobin levels and bone density, there's less certain evidence when it comes to the effects on child health.

The researchers said the preconception period is a good opportunity for healthcare professionals and others to encourage a healthy lifestyle, including a better diet. They also found that pregnancy planning is more common than previously thought, with around 60% of pregnancies worldwide being intentional.

The review said reaching a healthy weight might take 6 to 12 months, and embedding healthy dietary habits could take even longer. It suggested that "early intervention at a population level", starting in adolescence, is likely to be more successful than simply targeting individuals who are pregnant or planning to get pregnant.

What is the preconception period?

The study said we can think about this in 3 ways.

For most people, the preconception period starts when a couple or woman decide they want to have a baby. At this point, they can start to plan improvements to health and lifestyle – such as adopting a healthier diet, losing weight or quitting smoking – before they stop using contraception or take other steps to get pregnant.

The "biological" preconception period spans the weeks before pregnancy, when eggs and sperm mature and are released, fertilisation occurs and the developing embryo forms. At this time, environmental factors, such as micronutrients and exposure to smoking or alcohol, are crucial in the formation of a healthy embryo.

From a public health perspective, the authors suggested thinking about preconception as starting in adolescence, when most people are not planning a pregnancy but are adopting lifestyle health behaviours that may persist throughout their adult lives.

How does preconception health affect you?

If you're planning a pregnancy or think you would like to have a child in future, the message from the review is that there are plenty of things you can do to help have a healthy pregnancy and child.

These include:

  • eating a balanced diet, with at least 5 portions of fruit and veg a day
  • aiming for or maintaining a healthy weight for your height
  • not smoking
  • reducing alcohol intake – the advice in the UK is to not drink alcohol while trying to get pregnant
  • starting to take folic acid supplements – you need to take them for 4 to 6 weeks before you get pregnant

Find out more about planning a pregnancy.

Analysis by Bazian
Edited by NHS Choices