Hill Briony, Skouteris Helen, Teede Helena J, Bailey Cate, Baxter Jo-Anna B, Bergmeier Heidi J, Borges Ana Luiza Vilela, Harrison Cheryce L, Jack Brian, Jorgensen Laura, Lim Siew, Montanaro Cynthia, Redman Leanne, Steegers Eric, Stephenson Judith, Sundseth Hildrun, Thangaratinam Shakila, Walker Ruth, Boyle Jacqueline A
Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, Victoria 3168, Australia.
Warwick Business School, Warwick University, Coventry CV4 7AL, UK.
J Clin Med. 2019 Dec 2;8(12):2119. doi: 10.3390/jcm8122119.
The preconception period is a key public health and clinical opportunity for obesity prevention. This paper describes the development of international preconception priorities to guide research and translation activities for maternal obesity prevention and improve clinical pregnancy outcomes. Stakeholders of international standing in preconception and pregnancy health formed the multidisciplinary Health in Preconception, Pregnancy, and Postpartum (HiPPP) Global Alliance. The Alliance undertook a priority setting process including three rounds of priority ranking and facilitated group discussion using Modified Delphi and Nominal Group Techniques to determine key research areas. Initial priority areas 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. Five preconception research priorities and four overarching principles were identified. The priorities were: healthy diet and nutrition; weight management; physical activity; planned pregnancy; and physical, mental and psychosocial health. The principles were: operating in the context of broader preconception/antenatal priorities; social determinants; family health; and cultural considerations. These priorities provide a road map to progress research and translation activities in preconception health with future efforts required to advance evidence-translation and implementation to impact clinical outcomes.
孕前阶段是预防肥胖的关键公共卫生和临床契机。本文描述了国际孕前优先事项的制定情况,以指导预防孕产妇肥胖的研究与转化活动,并改善临床妊娠结局。在孕前和孕期健康领域具有国际影响力的利益相关者组成了多学科的孕前、孕期及产后健康全球联盟(HiPPP)。该联盟开展了一个确定优先事项的过程,包括三轮优先排序,并采用改良德尔菲法和名义群体技术促进小组讨论,以确定关键研究领域。初始优先领域基于对国际和国家临床实践指南、世界卫生组织关于孕前和孕期保健的建议,以及HiPPP成员的消费者和专家意见的系统综述。确定了五个孕前研究优先事项和四项总体原则。优先事项为:健康饮食与营养;体重管理;身体活动;计划妊娠;以及身心健康和社会心理健康。原则为:在更广泛的孕前/产前优先事项背景下开展工作;社会决定因素;家庭健康;以及文化考量。这些优先事项为推进孕前健康研究和转化活动提供了路线图,未来还需要努力推动证据转化与实施,以影响临床结局。