Zahra Ali Padhani and Zohra Lassi
When you hear ‘maternal health’, an image of a pregnant woman or new mother may spring to mind. But maternal health doesn’t begin at conception – it encompasses the choices people make about their health in the lead up to pregnancy too.
Much attention has been directed to maternal health from pregnancy onwards, and deservedly so. But interventions before conception are equally crucial for optimising long-term maternal, perinatal, and child health.
Preconception care encompasses all healthcare interventions provided before pregnancy to improve outcomes for both parents and their children. This covers family planning, nutrition, vaccinations, tobacco and substance use prevention, management of existing health conditions and more.
Adolescents and young adults are particularly vulnerable to slipping between the cracks when it comes to preconception care.
Our Evidence Gap Map (EGM) highlights critical gaps in preconception care interventions for adolescents and young adults, emphasising the urgent need for more focused research and policy action.
Adolescence shapes our future health and wellbeing
Adolescence is a critical window – a time of rapid physical, emotional, developmental, and social change. Young people (aged 10 to 24) are often vulnerable to risky behaviours, such as unprotected sex, smoking, substance abuse, and poor nutrition, all of which can have long-term consequences for their reproductive health.
Preconception care during this stage represents a unique opportunity to address these risks early, improving future pregnancy and birth outcomes.
Our findings
Despite its importance, preconception care for adolescents and young adults remains largely overlooked in research, policy, and practice. It’s time to change that.
The recent Evidence Gap Map sheds light on critical gaps and opportunities in preconception care research and interventions for adolescents and young adults.
Key areas like sexually transmitted infections (STI) prevention, nutrition education, mental health support, family planning, domestic violence prevention, environmental exposure impacts, and genetic counselling remain underexplored.
We also noticed a striking gender disparity: most studies focus on females, with minimal attention given to the preconception health of males. This neglects the crucial role men play in reproductive health and healthy pregnancies – perpetuating the myth that men’s health doesn’t affect pregnancy or child health outcomes.
There is also a lack of evidence on interventions delivered through schools, digital platforms, or community-based programs – approaches that could be more accessible and impactful for young people.
Another major gap is the scarcity of long-term outcome data, making it difficult to assess the true effectiveness of preconception interventions.
What’s next?
Research must shift its focus towards comprehensive preconception health interventions, including developing and evaluating school- and community-based programs and leveraging digital platforms to reach young people more effectively.
There is also a pressing need to focus on diverse populations, particularly Indigenous communities, people from low- and middle-income countries, those living in remote areas, and individuals living with disabilities.
Equally important is prioritising male preconception health, an area that has long been overlooked. Long-term follow-up studies are also essential to better understand the impact of early interventions on future pregnancy and child health outcomes.
For policymakers, healthcare providers, and researchers, this should serve as both a wake-up call and a roadmap.
The challenge now is to expand our understanding of effective interventions and ensure they are accessible to all adolescents and young adults, regardless of gender or location.
This is not just about better research; it’s about creating healthier futures for both parents and children.
Zahra Ali Padhani is a PhD Student in the School of Public Health, a Research Officer at the University of Adelaide and a committee member of the PHAA Health Promotion Special Interest Group (SIG). Associate Professor Zohra Lassi is based at the School of Public Health, University of Adelaide, is affiliated with Robinson Research Institute, and is Co-Convenor of the PHAA Women’s Health SIG.
Image: Antoni Shkraba/Pexels
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