Under embargo to Monday 16 March 2026, 23:30 UK time
Peer reviewed / Survey
The key health and social indicators needed for a new global system to monitor people’s health before pregnancy have been identified for the first time by researchers at University College London and the University of Southampton.
As more women are becoming pregnant with health conditions that can complicate pregnancy and childbirth, such as obesity, diabetes and mental illness, pre-pregnancy health has been thrown into the spotlight.
In a new paper published in The Lancet, the researchers present, for the first time, a long list of indicators which could be used globally to monitor the health of people of reproductive age - including both men and women* - before pregnancy.
Importantly, these identified metrics reflect not only healthcare professionals’ views but for the first time, also those of the general public.
The researchers had previously looked at relevant health indicators already monitored in England, such as smoking rates and the use of folic acid supplements before pregnancy to reduce birth defects, producing a report on the state of the nation’s preconception health which was published by the Office for Health Improvement and Disparities in England in 2022.
In their new research, they asked more than 5,000 people from 13 countries, including Australia, Brazil and Ghana, what factors would matter most to them before a pregnancy.**
They found that answers to their surveys were remarkably consistent across country and gender, with mental health, physical health, supportive relationships and finances prioritised. These are therefore important factors that monitoring systems should reflect, they say.
At an international workshop in Geneva in November they will work with other researchers, clinicians, policy makers and members of the public, to finalise a list of indicators. They will then call on the World Health Organisation, the NHS and other agencies responsible for national health surveillance to incorporate the indicators, where possible, into existing infrastructures to enable monitoring of health before pregnancy globally.
Senior author Professor Judith Stephenson (UCL EGA Institute for Women's Health) 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 and the National Institute for Health and Care Research Southampton Biomedical Research Centre, said: “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.”
* The indicators cover both women and men, reflecting the paper’s finding that preconception health factors affect all people of reproductive age, not just those who may become pregnant.
** The full list of countries which took part in the researchers’ survey was Australia, Bangladesh, Belgium, Brazil, Canada, Qatar, Singapore, UK, Ghana, Kenya, Malaysia, South Africa and the USA.
Notes to Editors
For more information or to speak to the researchers involved, please contact Nick Hodgson, UCL Media Relations. T: +44 (0)7769 240209, E: nick.hodgson@ucl.ac.uk or Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.
Danielle Schoenaker, Jennifer Hall, Sarah Verbiest, Engelbert A. Nonterah, Wendy V. Norman, Ghadir Fakhri Al-Jayyousi, Hanan F. Abdul Rahim, Nadira Sultana Kakoly, Ana Luiza Vilela Borges, Danielle Mazza, Chee Wai Ku, Jerry Kok Yen Chan, Ilse Delbaere, Shane A. Norris, Eric Steegers, Geraldine Barrett, Gabriella Conti, Judith Stephenson, for the international Core Indicators for Preconception Health and Equity (iCIPHE) Alliance, ‘ Measuring progress in pregnancy planning and preconception health’ will be published in The Lancet on Monday 16 March 2026, 23:30 UK time and is under a strict embargo until this time.
The DOI will be https://doi.org/10.1016/S0140-6736(26)00192-3 and the paper will be published here as soon as the embargo lifts.
The 12 areas the indicators cover are:
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The Lancet
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Measuring progress in pregnancy planning and preconception health’
16-Mar-2026
WVN is supported as the Public Health Agency of Canada Chair in Family Planning Public Health Research (CIHR CPP-329455; 2014–2024) and as a Tier 1 Canada Research Chair in Family Planning Innovation (CRC-2023-00135; 2024–2032). WVN received payment as consultant expert witness from the Ontario Government, Office of the Attorney General, and reports roles on the Board of Directors with the Society of Family Planning (2016–2021) and International Federation of Abortion and Contraception Professionals (FIAPAC; 2024–2027). GC reports support from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement number 819752 DEVORHBIOSHIP – ERC-2018-COG) and the Leverhulme Trust under the Leverhulme Trust Prize. DS is supported by the National Institute for Health and Care Research (NIHR) through an NIHR Advanced Fellowship (NIHR302955) and the NIHR Southampton Biomedical Research Centre (NIHR203319). Data collection on public perspectives in Singapore was supported by the KKH Health Services Model of Care Transformation Fund (MoCTF) grant (MoCTF/01/2020, MoCTF/02/2020, and MoCTF/03/2020) and the Lien Foundation Optimising Maternal and Child Health Programme Fund. CWK and JKYC are supported by the National Medical Research Council, Ministry of Health, Singapore (NMRC/MOH-000596-00 [CWK] and NMRC/CSA-SI-008-2016, MOH-001266-01, MOH-001221-01, and MOH-000932-01 [JKYC]). Data collection on public perspectives in the UK was supported by a UCL Global Engagement Funds award to JS, DS, and JH. All other authors declare no competing interests. The views expressed in this paper are those of the authors and not necessarily those of the funders. The funders had no role or involvement in the content of this paper, including recruitment, data collection, analysis and interpretation. The authors were not precluded from accessing data presented in this paper, and they accept responsibility to submit for publication.