Trends in preconception risk factors among reproductive women in the Netherlands from 2015 to 2023

Abstract Background Optimizing preconception health of future parents improves the lifelong health of their offspring. More than half of future parents have at least one preconception risk factor associated with an increased risk of adverse pregnancy and childbirth outcomes. Monitoring these trends can help public health policymakers to stimulate and facilitate healthy pregnancy planning. However, national trends in preconception indicators in the Netherlands are unknown. Methods Using a modified Delphi technique, 25 preconception health indicators were selected covering wider determinants of health, emotional and social wellbeing, reproductive health, health behaviors and pre-existing conditions. Indicators were measured using nationwide self-reported data from the Preparing for Pregnancy website questionnaire among reproductive women (aged 18-45 years). Results This descriptive analysis focuses on the health behavior domain from 68,061 respondents to the Preparing for Pregnancy website questionnaire, with 46,694 (69%) non-pregnant women as the group of interest. These women were 30 years old on average, relatively high-educated and Dutch-origin compared to national averages in 2023 (68% vs. 56% and 87% vs. 72%, respectively). From 2015 to 2023, most indicators showed unfavorable trends. For instance, increases were observed in overweight (31% to 34%), alcohol use (45% to 62%), drug use (1.5% to 5.6%), sexually transmitted infections (13% to 16%), stress (20% to 29%), and not taking folic acid (43% to 47%). Smoking decreased from 13% to 11%. Conclusions This is the first presentation of national preconception health trends in the Netherlands. Among relatively high-educated and Dutch-origin women of reproductive age, unfavorable trends were observed in modifiable preconception risk factors. These findings highlight the need for continued monitoring, public health strategies, and broader implementation of preconception care to support future parents and their children. Key messages • Preconception risk factors, such as alcohol use and stress, increased from 2015 to 2023. • Ongoing monitoring and targeted public health strategies are needed to improve preconception health.