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

• Published in: BJOG : an international journal of obstetrics and gynaecology 2023-09, Vol.130 (10), p.1187-1195
• Main Authors: Schoenaker, Danielle A. J. M., Stephenson, Judith, Smith, Helen, Thurland, Kate, Duncan, Helen, Godfrey, Keith M., Barker, Mary, Singh, Claire, Alwan, Nisreen A.
• Format: Article
• Language: English
• Subjects: Abortion, Spontaneous; Body weight; Cross-Sectional Studies; Demography; England - epidemiology; Female; Folic Acid; Humans; Maternal child nursing; Overweight; Population studies; Preconception Care; preconception health; Pregnancy; Pregnancy complications; routine health data; Smoking; Social factors; Supplements; Surveillance; Womens health
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.17436

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. Linked article: This article is commented on by Mairead Black, pp. 1196 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471‐0528.17483.