Preconception care (PCC), addressing the health of women and their partner prior to pregnancy, is increasingly recognised as an essential element to achieve healthy outcomes for parents and their children. Assisting women and partners to optimise health through improved nutrition, physical activity, and a healthy weight prior to pregnancy can promote positive child health outcomes and reduce the likelihood of future childhood obesity.[1]
- Ask about planning a pregnancy, and ask permission to discuss and assess preconception health behaviours and weight, and explain their relevance.
- Advise of healthy weight range.
- Assist to set SMART goals.
- Referral to allied health services if identified as at-risk.
- Ask for a follow up appointment for goal monitoring.
Assessing preconception weight, nutrition, physical activity and health behaviours is important for both parents and their future children. There is increasing evidence that suggests the environment and behaviours before conception can affect future health outcomes through gene expression. When parents are above a healthy weight this can predispose their children to health complications such as childhood obesity and development of diabetes later in life[1].
Other health assessments relevant to this time period include:[3]
- Vaccination status
- Smoking status
- Alcohol and Illicit drug use
- Psychosocial environment
- Medical conditions including screening for infectious diseases
- Nutritional requirements including folic acid supplementation
Resources below can assist you to raise the topic of weight and accurately assess weight:
Resource
Author
Advise, assist, and empower your patients.
Discuss with each individual the importance of positive health behaviours for personal health and the health of their future children. Where behaviour changes are required, you can work with individuals to create SMART goals which are achievable and sustainable, and which are more likely to become habits.
Healthy eating:
The Healthy Eating for Adults resource outlines the amount of food and drinks adults are recommended to consume each day, along with tips and information
Physical Activity
The Australian Make Your Move resource for adults 18-64 years includes recommendations for incorporating physical activity and minimising sedentary behaviour.
Preconception health:
The Preparing for Your Healthy Pregnancy flyer outlines key behaviour changes recommended for women before pregnancy.
Further resources below can be used to educate and advise individuals to adopt healthy behaviour changes that will help them work towards achieving their health goals:
Resource
Author
Preconception Checklist for Men
Your Fertility (Department of Health & Vic Department of Health and Human Services)
Preconception Checklist for Women
Your Fertility (Department of Health & Vic Department of Health and Human Services)
When supporting individuals with behaviour change and weight management, it is important to arrange follow-up appointments to continue to measure and monitor progress and reflect on support required.
Up-to-date information about the assessment and management of a range of conditions can be found on HealthPathways. HealthPathways is delivered across Queensland thanks to the support of Clinical Excellence Queensland, and you can find your local HealthPathways website here.
Programs listed below may help facilitate health behaviour change for individuals, or provide additional support or management where appropriate:
Resource
Author
Health professionals are recommended to upskill in best-practice prevention care during the preconception period to support the health of both parents and the future generation. This includes support of health behaviours and prevention, treatment, and management of individuals with overweight or obesity.
Further resources to upskill in preconception care can be found below:
Resource
Format
Author
Comorbidities of obesity and preconception counselling: Consideration of bariatric surgery
Journal Article
RACGP
Preconception health promotion in primary care
elearning
APNA - Australian Primary Health Care Nurses Association
Pre-conception
The RANZCOG best practice statement of Pre-pregnancy counselling summarises the key recommendations to detect and assess any health conditions to be managed prior to pregnancy, and to omptimise health prior to pregnancy.
Healthy eating:
The Australian Dietary Guidelines resource summarises the key recommendations and the underlying evidence supporting food, diet and health relationships
Physical Activity
The Australian Physical Activity and exercise guidelines for adults includes recommendations for amount and type of activity.
Further clinical guidelines which may assist clinicians supporting the prevention, early intervention and management of overweight and obesity in preconception are included below:
Resource
Author
- Rath SR, Marsh JA, Newnham JP, Zhu K, Atkinson HC, Mountain J, et al. Parental pre‐pregnancy BMI is a dominant early‐life risk factor influencing BMI of offspring in adulthood. Obesity Science & Practice. 2016; 2:48-57.
- Aviram, A. H. (2011). Maternal obesity: implications for preganncy outcome and long-term risks – a link to maternal nutrition. International Journal of Gynaecology and Obstetrics, S6-10. doi: 10.1016/S0020-7292(11)60004-0.
- Royal Australia and New Zealand College of Obstetrics and Gynecology (RANZCOG). Pre-pregnancy Counselling. Best Practice Statement. 2021.
Clinicians Hub is brought to you by Health and Wellbeing Queensland in partnership with Allied Health Profession’s Office of Queensland, Clinical Excellence Queensland.
Last updated 22 December 2023
