Programming for Sustainable Health - Linking Maternal Health with NCD Prevention and Care Through Focus on Hyperglycemia in Pregnancy


Dr Anil Kapur, Bengaluru    01 February 2018

(NCDs) and maternal health are closely linked. NCDs such as diabetes, obesity and hypertension have significant adverse impact on maternal health and pregnancy outcome and through the mechanism of intrauterine programming, maternal health has impact on the burden of NCDs in future generations. The cycle of vulnerability to NCDs is repeated with increasing risk accumulation in subsequent generations. The fetal environment represented by the mother’s periconceptional and gestational health determines whether one starts life with a health ‘advantage’ or ‘handicap’, and it is on this ‘foundation’ that NCD risk factors play out in later life. People starting life with a ‘health handicap’ may be less able to withstand lifestyle risks and may be vulnerable to develop NCDs early compared to those starting with a ‘health advantage’. The links between NCDs and maternal health are important and require a more integrated approach to prevention and care at the primary care level. Greater efforts are needed to create awareness and understanding about these links amongst healthcare professionals, public health experts, policymakers and funders and to develop sustainable cost-effective models to address integration at the program level. Obstetricians, family physicians, internists and pediatricians must remain vigilant and ensure that protocols for screening, diagnosis and care are adhered not only during pregnancy but also in the postpartum period. Pregnancy offers a window of opportunity to provide maternal care services, not only to reduce the traditionally known maternal and perinatal morbidity and mortality indicators but also for intergenerational prevention of several chronic diseases.

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