Preconception health in adolescence and adulthood across generations in the UK: findings from three British birth cohort studies

Optimising preconception health in women and men holds significant potential for improving pregnancy and offspring health outcomes. To create a picture of the state of preconception health in the UK, this study aimed to describe the prevalence of and changes in preconception health indicators reported in three British birth cohort studies: the 1970 British Birth Cohort Study (BCS70; born in 1970; N=17,198), Next Steps (1989-1990; N=15,770), and Millennium Cohort Study (MCS; 2000-2002; N=19,517). The analysis focused on data obtained during participants adolescence (16-17 years) and subsequent follow-ups at 25-26 years for BCS70 and Next Steps. Self-reported preconception indicators were defined in line with a previously published review and reported as proportions. Across cohorts, data were available for 14 preconception indicators across four domains: health behaviours and weight, reproductive health and family planning, physical health conditions, and wider determinants of health. Findings revealed persistent suboptimal health behaviours in both genders and across generations, including low intakes of fruit. While alcohol, tobacco, and soft drink intake decreased across generations, obesity prevalence surged. This study underscores the need for public health interventions targeting the root causes of adverse health behaviours towards improvement of fruit consumption, further reduction in alcohol, tobacco, and soft drink consumption, and addressing the escalating obesity rates among individuals of reproductive age. Ongoing monitoring is needed to continue tracking these existing indicators over time, while improved data quality and availability of a wider range of preconception indicators are crucial to comprehensively understanding the complexities of preconception health, enabling the development of more targeted and effective interventions.