New guidelines, position paper, and insights from the FIGO Pregnancy Obesity and Nutrition Initiative (PONI)

• Provide key messages and a strong narrative relating to the importance of tackling malnutrition and obesity before, during, and after pregnancy to improve the long‐term health of mothers, their children, and future generations. • Share and disseminate FIGO’s evidence‐based guidelines, checklists, and tools to support frontline services to “Think Nutrition and Weight First at Every Contact.” • Ensure a large range of stakeholders (i.e. member societies, frontline health professionals, partner nongovernment organizations) understand PONI’s messages, guidelines, available tools, and the way in which they can make a difference. • Provide publicity opportunities to increase uptake and implementation of PONI as a basis for further outreach and resource mobilization for FIGO’s Pregnancy and Non‐Communicable Diseases (PNCD) Committee.


The FIGO (International Federation of Gynecology and Obstetrics) Pregnancy Obesity and Nutrition Initiative (PONI) was launched in the
International Journal of Gynecology and Obstetrics (IJGO) in 2019. 1 The aims of the PONI are: • Provide key messages and a strong narrative relating to the importance of tackling malnutrition and obesity before, during, and after pregnancy to improve the long-term health of mothers, their children, and future generations.
• Share and disseminate FIGO's evidence-based guidelines, checklists, and tools to support frontline services to "Think Nutrition and Weight First at Every Contact." • Ensure a large range of stakeholders (i.e. member societies, frontline health professionals, partner nongovernment organizations) understand PONI's messages, guidelines, available tools, and the way in which they can make a difference.
• Provide publicity opportunities to increase uptake and implementation of PONI as a basis for further outreach and resource mobilization for FIGO's Pregnancy and Non-Communicable Diseases This Supplement of the IJGO publishes the results of the activities of the PONI group. It is published on behalf of FIGO's PNCD Committee.
The Supplement commences with a FIGO position paper on the prevention of noncommunicable diseases (NCDs) in the preconception period, which is a joint paper from FIGO's PNCD Committee and the Committee for Reproductive Medicine, Endocrinology, and Infertility. 2 It gives an overview of published clinical guidelines on nutrition and weight management in the preconception period and, based on this, provides a set of recommendations that can be adopted even in short consultations between a healthcare professional and a woman and her partner. The paper explores the barriers to preconception care and how they may be overcome, calling for concerted action and continuity of care by all healthcare professionals who come into contact with women in the preconception period, both before a first pregnancy and in the interpregnancy period of their lives. The PONI forms part of the activities of FIGO's PNCD Committee, so this paper is important as it recognizes that the prepregnancy or interpregnancy period is an increasingly critical time in reducing the risk of NCDs in the mother and their transmission to the next generation. The PONI work draws on the FIGO recommendations on adolescent, preconception, and maternal nutrition, which are a resource for use in all settings. Globally, economic progress in low-income populations is producing a transition in diets, physical activity, and lifestyle. India has a growing prevalence of obesity in both rural and urban populations, especially the latter. The paper in this Supplement by Chopra et al. 9 gives detailed information at the local level for the prevalence of obesity and its risk factors in pregnant and postpartum women in India. The authors took a mixed-methods approach, starting from a scoping review and analysis of a national dataset to build a picture of the problem, showing stark regional differences with the prevalence of obesity over 40% in over 30 districts of multiple states. Older maternal age, urban residence, greater wealth, and secondary school education were all associated with greater prevalence of obesity, bringing into sharp perspective the potential health hazards associated with increased economic prosperity in low-/ middle-income countries globally.
This collection of papers focusing on FIGO's PONI will empower specialists in obstetrics and gynecology, midwifery, and related healthcare professions to join the international mission being pioneered by FIGO to address the challenge of obesity and malnutrition before, during, and after pregnancy. We owe it to the parents and children of today and tomorrow to address this chronic, debilitating, and costly problem.

AUTHOR CONTRIBUTIONS
All authors contributed to writing the manuscript.