(Press-News.org) Under embargo to Monday 16 March 2026, 23:30 UK time
Peer reviewed / Survey
Major step towards a first global system to track health before pregnancy
The key health and social indicators needed for a new global system to monitor people’s health before pregnancy have been identified for the first time by researchers at University College London and the University of Southampton.
As more women are becoming pregnant with health conditions that can complicate pregnancy and childbirth, such as obesity, diabetes and mental illness, pre-pregnancy health has been thrown into the spotlight.
In a new paper published in The Lancet, the researchers present, for the first time, a long list of indicators which could be used globally to monitor the health of people of reproductive age - including both men and women* - before pregnancy.
Importantly, these identified metrics reflect not only healthcare professionals’ views but for the first time, also those of the general public.
The researchers had previously looked at relevant health indicators already monitored in England, such as smoking rates and the use of folic acid supplements before pregnancy to reduce birth defects, producing a report on the state of the nation’s preconception health which was published by the Office for Health Improvement and Disparities in England in 2022.
In their new research, they asked more than 5,000 people from 13 countries, including Australia, Brazil and Ghana, what factors would matter most to them before a pregnancy.**
They found that answers to their surveys were remarkably consistent across country and gender, with mental health, physical health, supportive relationships and finances prioritised. These are therefore important factors that monitoring systems should reflect, they say.
At an international workshop in Geneva in November they will work with other researchers, clinicians, policy makers and members of the public, to finalise a list of indicators. They will then call on the World Health Organisation, the NHS and other agencies responsible for national health surveillance to incorporate the indicators, where possible, into existing infrastructures to enable monitoring of health before pregnancy globally.
Senior author Professor Judith Stephenson (UCL EGA Institute for Women's Health) said: “This is an ongoing process to prioritise a set of internationally agreed core indicators for monitoring health before pregnancy.
“Our research found over 120 relevant indicators, far too many to include in a routine surveillance system, but through a rigorous collaborative process we have whittled that number down to around 40.
“Indicators relating to conception tend to be from a health professionals’ perspective – we have, for the first time, produced a set of agreed metrics which reflect the views of the general public. Together, these indicators will give us a more holistic view of health before people try to get pregnant.
“A strong international collaboration is now needed to achieve consensus on which core indicators can be compared across low-, middle- and high-income countries.”
Lead author Dr Danielle Schoenaker, from the University of Southampton and the National Institute for Health and Care Research Southampton Biomedical Research Centre, said: “There is growing evidence that supporting people to optimise health before and between pregnancies can improve pregnancy and birth outcomes and also reduce intergenerational inequalities and chronic disease risk.
“But without the right monitoring systems, governments and health services cannot easily see whether their policies and programmes are working.
“The right set of metrics could also steer future investment in care and support before pregnancy and parenthood, with a view to reducing health inequalities and improving health for future families.”
* The indicators cover both women and men, reflecting the paper’s finding that preconception health factors affect all people of reproductive age, not just those who may become pregnant.
** The full list of countries which took part in the researchers’ survey was Australia, Bangladesh, Belgium, Brazil, Canada, Qatar, Singapore, UK, Ghana, Kenya, Malaysia, South Africa and the USA.
Notes to Editors
For more information or to speak to the researchers involved, please contact Nick Hodgson, UCL Media Relations. T: +44 (0)7769 240209, E: nick.hodgson@ucl.ac.uk or Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.
Danielle Schoenaker, Jennifer Hall, Sarah Verbiest, Engelbert A. Nonterah, Wendy V. Norman, Ghadir Fakhri Al-Jayyousi, Hanan F. Abdul Rahim, Nadira Sultana Kakoly, Ana Luiza Vilela Borges, Danielle Mazza, Chee Wai Ku, Jerry Kok Yen Chan, Ilse Delbaere, Shane A. Norris, Eric Steegers, Geraldine Barrett, Gabriella Conti, Judith Stephenson, for the international Core Indicators for Preconception Health and Equity (iCIPHE) Alliance, ‘Measuring progress in pregnancy planning and preconception health’ will be published in The Lancet on Monday 16 March 2026, 23:30 UK time and is under a strict embargo until this time.
The DOI will be https://doi.org/10.1016/S0140-6736(26)00192-3 and the paper will be published here as soon as the embargo lifts.
The 12 areas the indicators cover are:
Wider determinants of health: Education, employment, ethnicity, migrant status, deprivation; plus system‑level factors such as housing, transport and working conditions.
Health care: Preconception checks, routine health reviews, dental care; access to services, trained providers, insurance coverage.
Emotional and social health: Social support, domestic abuse, family pressures; availability of support services.
Reproductive health and family planning: Pregnancy intention, contraception, fertility issues, obstetric history; access to contraception, fertility services and safe abortion.
Health behaviours and weight: Folic acid supplements, vitamin deficiency, diet, activity, sleep, smoking, alcohol, substances, BMI; food fortification policies, food insecurity, green space access.
Environmental exposures: Exposure to hazardous substances; air pollution, water safety and sanitation.
Preventive health screening: Cervical screening and access to screening programmes.
Immunisation and infections: Vaccination status, STIs, malaria, HIV, hepatitis; vaccination coverage and malaria prevention tools.
Mental health conditions: Diagnosed mental illness, stress levels, past perinatal mental illness; access to mental health services.
Physical health conditions: Diabetes, hypertension, epilepsy, asthma, Polycystic ovary syndrome (PCOS), endometriosis, cardiovascular disease and others; access to disease-specific check‑ups.
Medication: Use of medicines unsafe in pregnancy (e.g., valproate, warfarin); access to safer alternatives.
Genetic risk: Family history of inherited conditions, consanguinity; access to genetic screening.
About University College London (UCL)
UCL is a global top 10 university, set up in London 200 years ago to offer education for all. Today, we gather 60,000 staff and students, from over 150 countries, to create a unique city within a city – a research and innovation powerhouse that leads the world in subjects spanning the arts, sciences, technology and the humanities. We’ve nurtured 33 Nobel Prize winners, because here, brave ideas have the scale and the support they need to succeed. We are University College London. And here, it can happen.
UCL turns 200 in 2026. Join us for a year of bicentennial events and celebration.
www.ucl.ac.uk
The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2025). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 24,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 300,000 alumni. www.southampton.ac.uk
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END
Major step towards a first global system to track health before pregnancy
2026-03-17
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