For the first time, researchers have identified the key measures needed to monitor people’s health before they become pregnant, according to a study published in The Lancet. The authors from the University College London and the University of Southampton defend this is a move that could help improve outcomes for families around the world.
More people are entering pregnancy with health conditions such as obesity, diabetes and mental illness, which can complicate both pregnancy and childbirth. This has brought growing attention to the importance of health before conception, not just during it.
To build a picture of what matters most, the researchers surveyed more than 5,000 people across 13 countries, including Australia, Brazil and Ghana, asking what factors they would consider most important before a pregnancy. The answers were remarkably consistent regardless of country or gender: mental health, physical health, a supportive relationship and financial stability all came out on top.
This is significant because, until now, the measures used to track pre-pregnancy health have been shaped by healthcare professionals. This is the first time the views of the general public have been included on a global scale.
The team started with more than 120 potential indicators, including smoking, use of folic acid supplements, and mental wellbeing, and narrowed them down to around 40. The next step is an international workshop where researchers, doctors, policymakers and members of the public will agree on a final list. The team will then call on the World Health Organisation, the NHS and other health agencies to incorporate these measures into existing monitoring systems worldwide.
Professor Judith Stephenson of UCL 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, added: “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.”
Schoenaker D, Hall J, Verbiest S, Nonterah EA, Norman WV, Al-Jayyousi GF, Abdul Rahim HF, Kakoly NS, Borges ALV, Mazza D, Ku CW, Chan JKY, Delbaere I, Norris SA, Steegers E, Barrett G, Conti G, Stephenson J; international Core Indicators for Preconception Health and Equity (iCIPHE) Alliance. Measuring progress in pregnancy planning and preconception health. Lancet. 2026 Mar 16:S0140-6736(26)00192-3. doi: 10.1016/S0140-6736(26)00192-3.