17.F. Workshop: Building preconception care into existing health services: challenges and opportunities
Authors:   Organised by: PHAA Women's Health Special Interest Group,   Chair persons: Amie Steel - Australia, Danielle Schoenaker - UK
Published: October 2020

Abstract
Maternal health and health behaviours prior to conception have significant short and long term impacts on maternal and child health. The World Health Organization acknowledges the importance of health care before conception-referred to as 'preconception care' (PCC) -to reduce maternal and childhood morbidity and mortality. PCC is an approach to health promotion and preventive medicine that focuses on interventions that identify and modify biomedical, behavioural and social risks to a parental health or pregnancy outcome. By its nature, PCC relates to care before pregnancy, whether it be a first pregnancy or between consecutive pregnancies. PCC has received increased attention due to growing evidence that maternal health prior to conception can directly affect the health of the mother and the fetal environment during pregnancy. PCC research emphasises the impact of the fetal environment on adverse outcomes such as miscarriage, stillbirth, congenital disorders, and macrosomia. Parental preconception health also been found to impact on risk of the development of chronic diseases such as obesity, diabetes and cardiovascular disease, and cancer across the life course through epigenetic and other cellular responses to developmental exposures. Parental health behaviours that are important in the context of PCC include diet, smoking, and alcohol consumption. Similarly, parental exposure to environmental risk factors, such as phthalates, air pollution and pesticides can increase risk of congenital defects, behavioural issues and cancer in the child. Despite the importance of preconception health, and the potential impact of PCC, there are significant translation gaps between the available evidence and public awareness, clinician knowledge and available health services. This workshop aims to facilitate a deep and rich discussion about the challenges and opportunities associated with (1) improving preconception health in the general population and (2) developing PCC services and interventions that align with existing health services and meet population needs and expectations. The workshop will begin with four short presentations (10 minutes) to orient workshop participants to key literature with a focus on the following topics (1) the interface between public health and preconception health and care; (2) nutrition and lifestyle behaviours in the preconception period; (3) environmental exposures in the preconception period; and (4) considerations for person-centred PCC. Following these presentations, the workshop team will facilitate discussions among breakout groups to identify local challenges and opportunities. This workshop will conclude with a shared discussion consolidating the outcomes of the breakout discussions.

Key messages
Preconception care offers an untapped opportunity to leverage decades of research to develop initiatives that target couples before pregnancy and improve population health for multiple generations. Preconception health initiatives that address local challenges and opportunities may successfully modify parental health behaviours to reduce risk of chronic illness.