Promoting optimal fetal development
Report of a technical consultation
In December 2002, a group of experts met under the auspices of the WHO to discuss the desirability of developing a global strategy to reduce the prevalence of low birth weight (defined as a birth weight below 2500 grams). It became apparent that the development of a strategy that was focused on low birth weight per se alone would not address the central issue of ensuring a healthy start in life and that it would be more appropriate to work towards a strategy aiming to the optimization of fetal development in the broadest sense of the term. This theme was explored more fully during a follow-up Consultation held in November 2003, at which participants were requested to review current knowledge about the measurement, causes and consequences of sub-optimal fetal development and to propose next steps in the strategy development process. This report presents the findings of that Consultation.
There can be no doubt that early life events have a critical impact on human development, with consequences for biological and social function and behaviour over the entire life-course. It thus follows that any strategy which promotes a healthy start to life has the potential to improve a plethora of outcomes including infant and child survival, school performance and skills, health in infancy, childhood and adolescence, the health of the next generation of mothers and their fetuses, adult health and productivity. In other words, a strategy to optimize fetal development, if implemented, would not only have immediate health benefits, but also cumulative benefit for personal and social health and development for over many decades to come and as such would be in close accord with Millennium Development Goals.
In terms of interventions aimed at securing optimal fetal development, the Consultation highlighted the importance of a continued focus on the provision of basic health care and obstetric facilities and also the need for improved coordination in the delivery of health-care services to mother and child. The Consultation considered that the information needed to support the formulation of a holistic strategy for global application already existed, but acknowledged that some raw data still needed to be collected and analysed, and a number of core knowledge gaps that had yet to be addressed.