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Health and lifestyle before pregnancy can shape pregnancy outcomes. Growing evidence shows that a woman’s and a man’s health even before conception may influence pregnancy complications such as preeclampsia. A recent review from the 2023 Global Pregnancy Collaboration workshop summarized current research on preconception health and the “exposome,” which includes lifelong environmental and lifestyle exposures. The article highlights findings from clinical trials, population studies, and global health initiatives. Overall, the review concludes that improving preconception health offers important opportunities to reduce adverse pregnancy outcomes.
Health before pregnancy includes medical conditions, nutrition, stress levels, and environmental exposures. Research shows that not only diagnosed diseases, but also subtle changes in blood pressure, metabolism, and inflammation before pregnancy may increase the risk of complications such as preeclampsia. The article emphasizes that preconception health is shaped by many factors across the lifespan. Understanding these factors may help improve pregnancy outcomes and newborn health.
The review summarizes presentations from international experts at the 2023 Global Pregnancy Collaboration workshop. Researchers discussed physiology before pregnancy, environmental exposures, nutrition, stress, and digital health tools. Together, these perspectives highlight how multiple influences before conception may contribute to adverse pregnancy outcomes.
A key concept discussed is the “exposome,” which describes the total of environmental, behavioral, and social exposures across life. These exposures include diet, air pollution, smoking, stress, and social conditions. Research presented at the workshop showed that higher body mass index, insulin resistance, inflammation, and vascular stiffness before pregnancy were linked to later preeclampsia. Air pollution exposure, including fine particulate matter, was associated with a higher risk of preeclampsia and changes in placental development. Nutritional studies showed that many women had low levels of key vitamins before conception, and supplementation reduced micronutrient deficiencies and was associated with fewer preterm births.
The review also highlights the role of stress and allostatic load. Repeated stress may lead to hormonal and immune changes that affect pregnancy. However, not all individuals respond to stress in the same way. Researchers state the importance of understanding resilience and identifying which factors can protect against complications.
For parents of preterm infants and neonatal nurses, these findings underline the importance of health even before pregnancy begins. Expanding preconception counseling, promoting healthy nutrition, reducing environmental exposures, and supporting stress management may improve outcomes. Digital tools and community-based programs have shown promise in helping individuals improve lifestyle behaviors before conception.
Improving preconception health is a shared responsibility between families, clinicians, and public health systems. Talk with your neonatal team about preconception care and share this information with colleagues to raise awareness.
Paper available at: Preconception health as a target for improved pregnancy outcomes: Where do we go from here? - ScienceDirect
Full list of authors: Jancsura, M.K.; Bernstein, I.; Hansson, S.R.; Cantonwine, D.E.; Godfrey, K.M.; Stephenson, J.; Steegers-Theunissen, R.; Norris, S.; Heider, D.; Roberts, J.M.
DOI: 10.1016/j.preghy.2025.101395
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