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The University of Southampton

Few women follow healthy lifestyle guidelines before pregnancy

Published: 13 February 2009

A study by researchers at the University of Southampton, published online today by the BMJ, has found that very few women follow healthy eating and lifestyle recommendations before becoming pregnant, even when the pregnancy is in some sense planned.

Nutrition and lifestyle advice is widely available for women during pregnancy, but much less emphasis is given to advice for women who may become pregnant. Yet promoting good health and nutrition before pregnancy may be at least as important as during pregnancy, as the time around conception is vital for the development of the baby.

The Southampton research team, led by Professor Hazel Inskip of the University’s MRC Epidemiology Resource Centre, set out to examine the degree to which women comply with these recommendations before they become pregnant.

Between 1998 and 2002, they interviewed 12,445 non-pregnant women aged 20-34 years as part of the Southampton Women’s Survey, a general survey on women’s health. Information on participants’ diet, physical activity, smoking, alcohol consumption and nutritional supplement use over the past three months was recorded.

A total of 238 women became pregnant within three months of interview. These women were compared with those who did not become pregnant.

The women who became pregnant were only marginally more likely to comply with alcohol and folic acid recommendations than those who did not become pregnant. Among those who became pregnant only seven (2.9 per cent) were taking the recommended daily dose of 400µg folic acid and drinking no more than four units of alcohol per week, compared with 0.66 per cent of those who did not become pregnant.

The women who became pregnant were slightly less likely to smoke than those who did not become pregnant (74 per cent compared with 69 per cent were non-smokers) but this difference was not statistically significant.

Women in both groups were equally likely to consume five or more portions of fruit and vegetables per day, but only 57 per cent of those who became pregnant had taken any strenuous exercise in the past three months, compared with 64 per cent of those who did not become pregnant.

At interview, 55 (23 per cent) of the 238 women who became pregnant said that they did not anticipate trying for a baby in the next 12 months. Among this ‘unplanned' group only one woman (1.8 per cent) who became pregnant complied with the alcohol and folic acid recommendations, but among the remainder, who were, in some sense, ‘planning' a pregnancy, the percentage was only slightly higher at 3.3 per cent (six women).

Commenting on the findings, Professor Inskip says: “Our findings show limited evidence of changes in health behaviours before pregnancy.

“There is substantial research evidence already available showing that a woman’s health before pregnancy and in the early stages of pregnancy can affect the health of her baby, so wider publicity for pre-pregnancy recommendations would be of great benefit. However, the substantial unplanned pregnancy rates observed, suggest that greater efforts are needed to improve the nutrition and lifestyles of all women of child-bearing age.”

Notes for editors

The study ‘Women’s compliance with nutrition and lifestyle recommendations before pregnancy: general population cohort’ is published by the BMJ Online at

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