Table 2.

Good clinical practice recommendations for prepregnancy obesity (timepoint A)

Recommendation		Strength
A.1.1	Primary care services should support women of childbearing age with weight management before pregnancy and body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) should be measured. Advice on weight and lifestyle should be given during periodic health examinations, preconception counselling, contraceptive consultations, or other gynecologic care prior to pregnancy.	Conditional
A.2.1	Women of childbearing age with obesity should receive information and advice about the effect of obesity on fertility and the risks of obesity during pregnancy and childbirth.	Conditional
A.2.2	Assessment for sleep apnea and other conditions that could affect health during pregnancy, including those of the cardiac, pulmonary, renal, endocrine, and skin systems is warranted in the preconception period.	Conditional
A.3.1	Weight management strategies prior to pregnancy could include dietary, exercise, medical, and surgical approaches. Diet and exercise are the cornerstone of weight management in preconception and pregnancy.	Conditional
A.4.1	Women with a BMI ≥30 wishing to become pregnant should be advised to take a folic acid supplement daily, starting at least 1–3 months before conception and continuing during the first trimester of pregnancy. The dose should be at least 0.4 mg (400 μg) and consideration should be given to a higher dose (5 mg) as obesity is a risk factor for neural tube defects.	Strong