Wednesday, March 18, 2026

Major step towards a first global system to track health before pregnancy

University of Southampton

The key health and social indicators needed for a new global system to monitor people’s health before pregnancy have been identified for the first time by researchers at University College London and the University of Southampton.

As more women are becoming pregnant with health conditions that can complicate pregnancy and childbirth, such as obesity, diabetes and mental illness, pre-pregnancy health has been thrown into the spotlight.

In a new paper published in The Lancet, the researchers present, for the first time, a long list of indicators which could be used globally to monitor the health of people of reproductive age - including both men and women* - before pregnancy.

Importantly, these identified metrics reflect not only healthcare professionals’ views but for the first time, also those of the general public.

The researchers had previously looked at relevant health indicators already monitored in England, such as smoking rates and the use of folic acid supplements before pregnancy to reduce birth defects, producing a report on the state of the nation’s preconception health which was published by the Office for Health Improvement and Disparities in England in 2022.

In their new research, they asked more than 5,000 people from 13 countries, including Australia, Brazil and Ghana, what factors would matter most to them before a pregnancy.**

They found that answers to their surveys were remarkably consistent across country and gender, with mental health, physical health, supportive relationships and finances prioritised. These are therefore important factors that monitoring systems should reflect, they say.

At an international workshop in Geneva in November they will work with other researchers, clinicians, policy makers and members of the public, to finalise a list of indicators. They will then call on the World Health Organisation, the NHS and other agencies responsible for national health surveillance to incorporate the indicators, where possible, into existing infrastructures to enable monitoring of health before pregnancy globally.

Senior author Professor Judith Stephenson (UCL EGA Institute for Women's Health) said: “This is an ongoing process to prioritise a set of internationally agreed core indicators for monitoring health before pregnancy.

“Our research found over 120 relevant indicators, far too many to include in a routine surveillance system, but through a rigorous collaborative process we have whittled that number down to around 40.

“Indicators relating to conception tend to be from a health professionals’ perspective – we have, for the first time, produced a set of agreed metrics which reflect the views of the general public. Together, these indicators will give us a more holistic view of health before people try to get pregnant.

“A strong international collaboration is now needed to achieve consensus on which core indicators can be compared across low-, middle- and high-income countries.”

Lead author Dr Danielle Schoenaker, from the University of Southampton and the National Institute for Health and Care Research Southampton Biomedical Research Centre, said: “There is growing evidence that supporting people to optimise health before and between pregnancies can improve pregnancy and birth outcomes and also reduce intergenerational inequalities and chronic disease risk.

“But without the right monitoring systems, governments and health services cannot easily see whether their policies and programmes are working.

“The right set of metrics could also steer future investment in care and support before pregnancy and parenthood, with a view to reducing health inequalities and improving health for future families.”

* The indicators cover both women and men, reflecting the paper’s finding that preconception health factors affect all people of reproductive age, not just those who may become pregnant.

** The full list of countries which took part in the researchers’ survey was Australia, Bangladesh, Belgium, Brazil, Canada, Qatar, Singapore, UK, Ghana, Kenya, Malaysia, South Africa and the USA.

Notes to Editors

For more information or to speak to the researchers involved, please contact Nick Hodgson, UCL Media Relations. T: +44 (0)7769 240209, E: nick.hodgson@ucl.ac.uk or Steve Williams, Media Manager, University of Southampton, press@soton.ac.uk or 023 8059 3212.

Danielle Schoenaker, Jennifer Hall, Sarah Verbiest, Engelbert A. Nonterah, Wendy V. Norman, Ghadir Fakhri Al-Jayyousi, Hanan F. Abdul Rahim, Nadira Sultana Kakoly, Ana Luiza Vilela Borges, Danielle Mazza, Chee Wai Ku, Jerry Kok Yen Chan, Ilse Delbaere, Shane A. Norris, Eric Steegers, Geraldine Barrett, Gabriella Conti, Judith Stephenson, for the international Core Indicators for Preconception Health and Equity (iCIPHE) Alliance, ‘Measuring progress in pregnancy planning and preconception health’ will be published in The Lancet on Monday 16 March 2026, 23:30 UK time and is under a strict embargo until this time.

The DOI will be https://doi.org/10.1016/S0140-6736(26)00192-3 and the paper will be published here as soon as the embargo lifts.

The 12 areas the indicators cover are:

Wider determinants of health: Education, employment, ethnicity, migrant status, deprivation; plus system‑level factors such as housing, transport and working conditions.
Health care: Preconception checks, routine health reviews, dental care; access to services, trained providers, insurance coverage.
Emotional and social health: Social support, domestic abuse, family pressures; availability of support services.
Reproductive health and family planning: Pregnancy intention, contraception, fertility issues, obstetric history; access to contraception, fertility services and safe abortion.
Health behaviours and weight: Folic acid supplements, vitamin deficiency, diet, activity, sleep, smoking, alcohol, substances, BMI; food fortification policies, food insecurity, green space access.
Environmental exposures: Exposure to hazardous substances; air pollution, water safety and sanitation.
Preventive health screening: Cervical screening and access to screening programmes.
Immunisation and infections: Vaccination status, STIs, malaria, HIV, hepatitis; vaccination coverage and malaria prevention tools.
Mental health conditions: Diagnosed mental illness, stress levels, past perinatal mental illness; access to mental health services.
Physical health conditions: Diabetes, hypertension, epilepsy, asthma, Polycystic ovary syndrome (PCOS), endometriosis, cardiovascular disease and others; access to disease-specific check‑ups.
Medication: Use of medicines unsafe in pregnancy (e.g., valproate, warfarin); access to safer alternatives.
Genetic risk: Family history of inherited conditions, consanguinity; access to genetic screening.

About University College London (UCL)

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The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2025). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 24,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 300,000 alumni. www.southampton.ac.uk

www.southampton.ac.uk/news/contact-press-team.page

Journal

The Lancet

DOI

10.1016/S0140-6736(26)00192-3

Method of Research

Survey

Subject of Research

People

Article Title

Measuring progress in pregnancy planning and preconception health’

Article Publication Date

16-Mar-2026

COI Statement

WVN is supported as the Public Health Agency of Canada Chair in Family Planning Public Health Research (CIHR CPP-329455; 2014–2024) and as a Tier 1 Canada Research Chair in Family Planning Innovation (CRC-2023-00135; 2024–2032). WVN received payment as consultant expert witness from the Ontario Government, Office of the Attorney General, and reports roles on the Board of Directors with the Society of Family Planning (2016–2021) and International Federation of Abortion and Contraception Professionals (FIAPAC; 2024–2027). GC reports support from the European Research Council under the European Union’s Horizon 2020 research and innovation programme (grant agreement number 819752 DEVORHBIOSHIP – ERC-2018-COG) and the Leverhulme Trust under the Leverhulme Trust Prize. DS is supported by the National Institute for Health and Care Research (NIHR) through an NIHR Advanced Fellowship (NIHR302955) and the NIHR Southampton Biomedical Research Centre (NIHR203319). Data collection on public perspectives in Singapore was supported by the KKH Health Services Model of Care Transformation Fund (MoCTF) grant (MoCTF/01/2020, MoCTF/02/2020, and MoCTF/03/2020) and the Lien Foundation Optimising Maternal and Child Health Programme Fund. CWK and JKYC are supported by the National Medical Research Council, Ministry of Health, Singapore (NMRC/MOH-000596-00 [CWK] and NMRC/CSA-SI-008-2016, MOH-001266-01, MOH-001221-01, and MOH-000932-01 [JKYC]). Data collection on public perspectives in the UK was supported by a UCL Global Engagement Funds award to JS, DS, and JH. All other authors declare no competing interests. The views expressed in this paper are those of the authors and not necessarily those of the funders. The funders had no role or involvement in the content of this paper, including recruitment, data collection, analysis and interpretation. The authors were not precluded from accessing data presented in this paper, and they accept responsibility to submit for publication.

Top AI coding tools make mistakes one in four times

Benchmarking research shows leading AI models still struggle to reliably produce structured outputs used in software development

University of Waterloo

New research from the University of Waterloo shows that artificial intelligence (AI) still struggles with some basic software development tasks, raising questions about how reliably AI systems can assist developers.

As Large Language Models (LLMs) are increasingly incorporated into software development, developers have struggled to ensure that AI-generated responses are accurate, consistent, and easy to integrate into larger development workflows.

Previously, LLMs responded to software development prompts with free-form natural language answers. To address this problem, several AI companies, including OpenAI, Google and Anthropic, have introduced “structured outputs”. These outputs force LLM responses to follow predefined formats such as JSON, XML, or Markdown, making them easier for both humans and software systems to read and process.

A new benchmarking study from Waterloo, however, shows that the technology is not yet as reliable as many developers had hoped. Even the most advanced models achieved only about 75 per cent accuracy in the tests, while open-source models performed closer to 65 per cent.

The study evaluated 11 LLM models across 18 structured output formats and 44 tasks designed to assess how reliably the systems followed structured rules.

“With this kind of study, we want to measure not only the syntax of the code – that is, whether it’s following the set rules – but also whether the outputs produced for various tasks were accurate,” said Dongfu Jiang, a PhD student in computer science and co-first author on the research. “We found that while they do okay with text-related tasks, they really struggle on tasks involving image, video, or website generation.”

The study was a collaborative effort involving Waterloo’s Jialin Yang, an undergraduate student, and Dr. Wenhu Chen, an assistant professor of computer science, and incorporated annotations from 17 other researchers at Waterloo and around the world.

“There have been a lot of similar benchmarking projects happening in our labs recently,” Chen said. “At Waterloo, students often begin as annotators, then organize projects and create their own benchmarking studies. They’re not just using AI in their studies – they’re building, researching and evaluating it.”

While LLM-structured outputs are an exciting step for software development, the researchers say the systems are not yet reliable enough to operate without human oversight. “Developers might have these agents working for them, but they still need significant human supervision,” Jiang said.

The research, “StructEval: Benchmarking LLMs’ Capabilities to Generate Structural Outputs,” appears in Transactions on Machine Learning Research and will be presented at ICLR 2026.

DOI

10.48550/arXiv.2505.20139

A new bird species in Japan

PNAS Nexus

image:
A singing male Tokara Leaf Warbler, *Phylloscopus tokaraensis*, on Nakanoshima, Tokara Islands, in June 2017.
view more
Credit: Per Alström

An island bird species discovered in Japan looks just like a similar species from 1,000 km away, but has been genetically isolated for millions of years. Takema Saitoh, Per Alström, and colleagues report the existence of the Tokara Leaf Warbler, a small insectivorous songbird with an olive-green back and a silvery gray breast from the Tokara Islands in Japan. The Tokara Leaf Warbler is a cryptic species that looks identical to Ijima’s Leaf Warbler (Phylloscopus ijimae) from the Izu Islands. However, genetic analysis reveals that the lineages diverged around 2.8–3.2 million years ago, and there’s no evidence of any contemporary gene flow between the island groups. Genetic divergence between the birds is twice as large as the divergence between the Collared Flycatcher (Ficedula albicollis) and the European Pied Flycatcher (F. hypoleuca), which live in overlapping ranges without any genetic exchange. In addition, the two leaf warblers sing different songs. Ijima’s Leaf Warblers were already listed as vulnerable by the International Union for Conservation of Nature (IUCN). The understanding that the group comprises two separate species suggests the need for a fresh evaluation of each species’ conservation status. The Tokara Leaf Warbler faces threats from introduced weasels (Mustela itatsi) and environmental modification by domestic goats, as well as potential threats from volcanic eruptions, as the Tokara Islands are volcanic and show signs of activity. The authors propose the name Phylloscopus tokaraensis for the species.

One of the Tokara Leaf Warblers, Phylloscopus tokaraensis, caught on Nakanoshima, Tokara Islands, in June 2017.

Credit

Per Alström

Tokara Leaf Warbler Song [AUDIO] |