Tackling NCD transmission together

Human health starts from the moment of conception, continuing during fetal and child development.

Understanding that Noncommunicable Diseases (NCDs) are in fact communicable across generations opens new possibilities for early interventions - and a collaborative approach between OBGYNs and midwives to implement them

Too often the health care system is fragmented, which can lead to confusing messages for patients and the public; but pregnancy is a period of the life-course when more women are likely to access health care. OBGYNs and midwives are extraordinarily well‐placed to integrate early life risk reduction for NCDs into routine care.

Although OBGYN and midwife roles and remits differ globally, working collaboratively will help spread the message about early interventions to prevent the passage of NCD risk to the next generation. Platforms providing access to this period can be harnessed to engage women and couples effectively in prevention of NCD transmission.

Our colleagues in these specialities can have an enormous influence on prospective parents, helping them to have a healthy pregnancy outcome, and ensuring that the next generation start life on a healthy curve.

The roles of midwives and OBGYNs are so much greater than simply delivering a healthy baby – they help establish the trajectory of health for life. The period before and during pregnancy is critical for establishing healthy trajectories of child growth and body composition, neurocognitive and emotional development - which further influences school-readiness and educational attainment.

We all want the best for the next generation, and improving their life chances is not hard if we start early. This is why preventive efforts also need to be community-based, linked to education and wider initiatives aimed at improving population health. In many ways, this is an agenda to promote health across the life course.

Strategies based on such a life course approach are underpinned by principles of human rights and equity, and complementary to efforts to achieve universal health coverage and health targets in the 2030 Sustainable Development Agenda - women’s health in particular.

At the University of Southampton, in association with FIGO’s Pregnancy and NCD Committee, we are launching a study that aims to increase awareness among health care practitioners about the risk of NCD transmission to the next generation.

We are interviewing OBGYNs and midwives to explore the barriers and supportive factors in communicating issues related to obesity, nutrition, gestational diabetes and other NCDs in routine practice. The findings will help us develop responsive tools to support risk assessment for NCDs during pregnancy and for future parents, and increase the application of this knowledge in routine practice to identify high-risk women.

Barriers to engaging with women, couples and children include delays in the first antenatal care visit, especially in low- and middle-income countries, and inadequate follow-up of health promotion initiatives after the child is born. Hence, we need a seamless support system, from adolescent health to reproductive health, and through antenatal, postnatal and inter-pregnancy care. Providing such a continuum of care  requires innovative initiatives, such as those driven by FIGO.

Stakeholders across the perinatal period urgently need to work together to raise awareness of the importance of the preconception period, as well as pregnancy and infancy with healthcare professionals and policy-makers. We also need to engage young people themselves, as the parents of tomorrow.

The health behaviours of prospective parents, even before conception, can have lasting effects on the next generation. Their health is in our hands, and we must give them the gift of the best start in life.

Prof Mark Hanson
Co-Chair, FIGO Pregnancy and NCDs Committee
Institute of Developmental Sciences, University of Southampton UK 

Dr Chandni Maria Jacob
Institute of Developmental Sciences, University of Southampton UK