Preconception health as a target for improved pregnancy outcomes: Where do we go from here?

Preconception health status, especially of women, but also of men, is known to influence pregnancy outcomes. Despite knowledge of the growing importance of preconception health, numerous challenges remain for conducting research in this population and delivering appropriate clinical care. The 2023 Global Pregnancy Collaboration annual workshop focused on exploring preconception health as it relates to adverse pregnancy outcomes. Here we summarize the proceedings and the current state of the science. We particularly focus on quantifying the exposome as a rich target for investigation of factors that increase the risk for and/ or contribute to preeclampsia and other adverse pregnancy outcomes. We conclude with recommendations for the scientific and clinical community to address knowledge gaps regarding the links between preconception health and adverse pregnancy outcomes.