Morbidity and mortality measures related to pregnancy-associated infant and maternal health have either remained stable or deteriorated worldwide over the past several years. Whitworth and Dowswell undertook an evidence-based review in the important area of prepregnancy health promotion interventions for improving pregnancy outcomes. The authors use the rationale that despite the enthusiasm among women and health professionals for routine pre-pregnancy care, evidence on its effectiveness is required before widespread implementation can be advocated. Unfortunately, only four studies were included in their review on the basis of the gold standard of randomised or quasi-randomised controlled trials. Selection criteria were stated as inclusion of studies of health promotion interventions (addressing smoking, excessive alcohol intake and poor nutrition) that aimed to identify and modify risk factors before pregnancy in all women …