SINGAPORE - Doctors at KK Women's and Children's Hospital (KKH) know that a woman's health can impact that of her child, even before it is conceived.
But seven months after they embarked on a study to find out the specifics of this link, they have hit a snag.
Only 277 women have signed up to be part of the study, and only 37 of these have become pregnant so far. The plan is to recruit 1,000 women by next year, with around 400 of them becoming pregnant.
To help encourage more people to sign up for the study, the hospital launched a pre-conception health clinic in August.
It offers screening tests to all women who are intending to have a child soon, and is open to everyone - not just those who sign up for the study.
However, while the public screening rate is $349, those who sign up for the Singapore Pre-conception Study of Long-term Maternal and Child Outcomes (S-Presto) will pay only $107.
Part of the reason for establishing the clinic, said Associate Professor Jerry Chan, who is director of the hospital's research centre, is to raise general awareness about the importance of pre-pregnancy health.
"We need to educate women about this, but there isn't any dedicated clinic to get it sorted out," Dr Chan said.
"We'll be able to pick up obvious problems with fertility, for example, and refer them to the appropriate care earlier."
While the hospital has a sub-fertility clinic, it is only for women who have already spent some time trying for a child. Other screening tests it offers focus more on general health and well-being.
The new clinic's screening package includes womb and ovary imaging, as well as blood tests to establish ovarian health and screen for infectious diseases.
Apart from having to undergo blood tests, women who are enrolled in the S-Presto study will have to answer in-depth questionnaires on their lifestyle and even emotional health.
Their children too will be closely tracked up to the age of two.
One patient who signed up for the study was enrolled nurse Nur Sastri Majid, 27. She was encouraged to do so by a friend last April and her daughter - the first baby born under the study - was born on Dec 31 last year.
"My friend encouraged me to sign up and I was planning to have a child so I thought why not give it a try," Ms Sastri said.
"So far they've done some home visits, to take her hair sample and height and weight."