Objectives Preconception care is important for the screening, prevention and management of risk factors that affect pregnancy outcomes. We aimed to investigate pre-pregnancy care policies, guidelines, recommendations and services in six European countries. Methods In 2013, an electronic search and investigation was undertaken of preconception policy, guidelines, recommendations and services available to healthcare professionals and the general public in six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom. Findings were compared within five categories: Governmental policy and legislation; Professional bodies and organisations; Healthcare providers; Charitable organisations; Web-based public information and internet sites. Results All countries had preconception recommendations for women with chronic diseases, such as diabetes and epilepsy. Recommendations for healthy women and men were fragmented and inconsistent. Preconception guidance was often included in antenatal and pregnancy guidelines. Differences between countries were seen with regard to nutritional and lifestyle advice particularly in relation to fish, caffeine and alcohol consumption, and vitamin supplementation. Conclusions Current guidelines are heterogeneous. Collaborative research across Europe is required in order to develop evidence-based guidelines for preconception health and care. There is a need to establish a clear strategy for promoting advice and guidance within the European childbearing population. Chinese Abstract 摘要 目的 孕前保健对于那些影响妊娠结局的风险因素的筛查、预防和管理是非常重要的。我们旨在调查六个欧洲国家的孕前保健政策、指南、推荐规范和服务项目 方法 2013年，一项服务于医疗专家和公众的电子搜索和调查项目在六个欧洲国家：比利时（弗兰德斯）、丹麦、意大利、荷兰、瑞典和英国展开。其结果从以下五个方面进行比较：政府政策和立法；专业团队和机构；医务人员；慈善组织；基于网络的公共信息和互联网站。 结果 所有国家对于患有慢性病的女性（如糖尿病和癫痫）均有相应的孕前推荐规范。而对于健康男女的推荐规范则比较分散且不一致。孕前指南常包括在产前和妊娠指南中。各个国家关于营养和生活方式的建议，尤其涉及鱼类、咖啡因、饮酒和维生素补充方面是不同的。 结论 现行的指南多种多样，需要整个欧洲进行合作研究，从而为孕前卫生保健制定循证指南。因此有必要为促进建议和指南在欧洲生育年龄人群中的实施建立清晰的方法。

Background. It has been questioned whether leisure time physical activity (LTPA) during pregnancy is beneficial or deleterious to pregnancy outcome, and whether a sedentary lifestyle during pregnancy has a negative impact on pregnancy. Answers to these questions are of general interest, since some young women are very physically active during leisure time, while others have a sedentary lifestyle. Method. In this review, we analysed the association between LTPA and the selected pregnancy outcomes, gestational diabetes mellitus (GDM), pre‐eclampsia, preterm delivery, and birth weight. Results. The prevailing literature clearly indicates that LTPA before and/or during pregnancy has a protective effect on the development of GDM and pre‐eclampsia. Furthermore, LTPA does not seem to have a negative impact on the rate of preterm delivery or on birth weight. Conclusion. Thus, it seems relevant that health authorities recommend 30 min of daily physical activity to healthy pregnant women.

Postponing parenthood has steadily increased during the past decades in Western countries. This trend has affected the size of families in the direction of fewer children born per couple. In addition, higher maternal age is associated with an increased risk of pregnancy-related complications such as prematurity and foetal death, while higher paternal age increases the risk of miscarriage and affects time-to-pregnancy. Hence, understanding the circumstances and reflections that influence the decision is greatly needed and little is known about potential gender difference influencing the choice. The aim was to investigate attitudes towards parenthood, intentions for childbirth and knowledge about fertility issues among men and women. We conducted a cross-sectional study based on a validated 49-item questionnaire among students, who attended selected mandatory lectures at a Danish university college in February to April 2016. The participation rate was 99%, and 517 completed the questionnaire. Though the majority of all participants wished to have children in the future (>86%), there was significant difference between the genders (p = 0.002). Women rated having children to be more important than men did (p < 0.001), while men rated higher the likelihood of abstaining from having children if faced with infertility (p = 0.003). Knowledge about fertility issues was similar between genders including poor knowledge about the age-related decline in female fertility. While women found it more important to have children before being ‘too old’ (p = 0.04), still more than 40% of all respondents intended to have their last child after the age of 35 years. For both genders the most important prerequisite for parenthood was having a partner to share responsibility with. Perceived or experienced life changes related to parenthood were generally positive such as personal development. The majority of respondents wished to have children, but many desired to have these after the biological decline in female fertility. The moderate knowledge level among both genders uncovered in this study is of concern. Future research should address the potential link between fertility knowledge and planning of parenthood. We may benefit from intervention studies examining the effect of routine preconception care.

OBJECTIVE: To investigate the association between maternal weight gain and birth weight less than 3,000 g and greater than or equal to 4,000 g in underweight (body mass index [BMI] less than 19.8 kg/m²), normal weight (BMI 19.8–26.0 kg/m²), overweight (BMI 26.1–29.0 kg/m²), and obese (BMI greater than 29.0 kg/m²) women, with emphasis on the use of the American Institute of Medicine (IOM) recommendations in Denmark. METHODS: We analyzed data from 2,248 women with singleton, term pregnancies. The relationship between weight gain and risk of birth weight less than 3,000 g and greater than or equal to 4,000 g was examined in the four BMI groups, and use of IOM recommendations was tested by logistic regression analyses. RESULTS: We found an inverse relationship between maternal weight gain and the proportion of infants with a birth weight less than 3,000 g. Birth weight greater than or equal to 4,000 g increased with an increasing weight gain in underweight and normal-weight women, but the association was less apparent in overweight and obese women. Underweight women seemed to benefit from gaining more weight than recommended by the IOM, because the odds ratio (OR) of birth weight less than 3,000 g was 0.3 (95% confidence interval [CI] 0.1–0.9) and the OR was 1.7 for birthweight greater than or equal to 4,000 g (95% CI 0.8–3.6). The normal-weight women had an increased risk of birth weight less than 3,000 g (OR 2.4, 95% CI 1.5–3.7) if weight gain was below the recommended range, and the OR of birth weight greater than or equal to 4,000 g was 1.9 (95% CI 1.5–2.5) when the women gained more than recommended. CONCLUSION: The IOM recommendations may provide a basis for Danish recommendations to pregnant women, although the upper recommended limit for underweight women may have to be increased. LEVEL OF EVIDENCE: II

National guidelines recommend that healthy pregnant women take 30 minutes or more of moderate exercise a day. Most women reduce the level of physical activity during pregnancy but only a few studies of women's experiences of physical activity during pregnancy exist. The aim of the present study was to elucidate experiences and views of leisure time physical activity during pregnancy in nulliparous women who were physically active prior to their pregnancy.