Background: High preconception weight status is a significant contributor to rising maternal obesity and associated health risks and hence the preconception period is a key public health opportunity for obesity prevention. However, there is an absence of established priorities to guide research and translation activities. Here, we describe the process of developing international preconception priorities to guide research and translation activities for maternal obesity prevention and improve related pregnancy and long-term complications.
Methods: Stakeholders of international standing in preconception and pregnancy health were invited to form the multidisciplinary Health in Preconception, Pregnancy, and Postpartum (HiPPP) Global Alliance; five continents were represented. The Alliance undertook a priority setting process to determine key research areas. Initial priority areas for ranking were based on a systematic review of international and national clinical practice guidelines, World Health Organization recommendations on preconception and pregnancy care, and consumer and expert input from HiPPP members. The process involved three rounds of priority ranking and facilitated group discussion using a Modified Delphi and Nominal Group Technique. During this process, key research, practice, and policy gaps were identified in the preconception health evidence-base.
Results: Consensus on five preconception research priorities was achieved: healthy diet and nutrition; weight management; physical activity; planned pregnancy; and physical, mental and psychosocial health. Four overarching principles that should be applied to each research priority were also identified: operating in the context of broader preconception/antenatal priorities; social determinants; family health; and cultural considerations. Research, practice and policy gaps included evidence synthesis, co-designed interventions, real world trials, and implementation research.
Conclusions: The established priorities provide a road map to progress research and translation activities in preconception health. Effort is needed to advance preconception research towards translation and implementation, including comprehensive endeavours to remove multidisciplinary barriers, reduce duplication, and promote efficient, collaborative, strategic, prioritised research.