Two of the greatest challenges facing reproductive science in many developed countries are dealt with by two studies in this week's BMJ.1 2 The first challenge is the need to find innovative approaches to prevent perinatal death, low birth weight, and preterm birth. The second is the challenge to our healthcare systems resulting from the attendance of large numbers of people of differing racial origins. Together, the findings from these two studies provide vital clues as to how healthcare outcomes may be improved by strategies aimed at the early stages of human life.

In the developed world, the outcome of pregnancy for both mother and child improved dramatically during the 20th century. Reproduction has never been as safe as it is today. Many of the advances that have contributed to improved outcomes have come from the application of medical discoveries in late pregnancy and …