Skip to main content

Advertisement

SpringerLink
Log in

Maternal Lifestyle Impairs Embryonic Growth: The Rotterdam Periconception Cohort

  • Original Article
  • Published:
Reproductive Sciences Aims and scope Submit manuscript

Abstract

Previously, embryonic growth has been assumed to be uniform, but in recent years, it has become more clear that genetic and environmental factors may influence the intrauterine environment and therefore embryonic growth trajectories as well as pregnancy course and outcome. The objective of this study was to investigate associations between modifiable maternal nutrition and lifestyle factors during the periconception period and embryonic growth. We established a prospective cohort including 342 women less than 13 weeks pregnant. At enrollment, women filled out a questionnaire regarding demographic and medical data and a validated food frequency questionnaire. Participants received multiple 3-dimensional ultrasound examinations up until the 12th week of pregnancy, and crown–rump length (CRL) and embryonic volume (EV) were measured offline using V-Scope Virtual Reality software (version 1.0.0) in a Barco I-Space. Associations between maternal periconception vegetable and fruit intake, folic acid supplement use, smoking, and alcohol consumption and embryonic growth measurements were assessed by linear mixed models adjusted for potential confounders. No or postconception initiation of folic acid supplement use was significantly associated with a 0.76 mm (−7.8%) and 1.63 mm (−3.7%) smaller CRL and a 0.01 cm3 (−19.5%) and 0.86 cm3 (−12.2%) smaller EV at 7+0 and 11+0 weeks of gestation, respectively. Smoking, alcohol consumption, and inadequate fruit and vegetable intake showed weaker associations with embryonic growth parameters. These results emphasize the influence of periconceptional maternal folic acid supplement use on embryonic growth. Results regarding maternal nutrition and lifestyle factors also suggest an association with embryonic growth, but this has to be confirmed in a larger study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Blaas HG, Eik-Nes SH, Bremnes JB. The growth of the human embryo. A longitudinal biometric assessment from 7 to 12 weeks of gestation. Ultrasound Obstet Gynecol. 1998;12(5):346–354.

    Article  CAS  PubMed  Google Scholar 

  2. van Uitert EM, Exalto N, Burton GJ, et al. Human embryonic growth trajectories and associations with fetal growth and birthweight. Hum Reprod. 2013;28(7):1753–1761.

    Article  PubMed  Google Scholar 

  3. Bottomley C, Daemen A, Mukri F, et al. Assessing first trimester growth: the influence of ethnic background and maternal age. Hum Reprod. 2009;24(2):284–290.

    Article  PubMed  Google Scholar 

  4. Mook-Kanamori DO, Steegers EA, Eilers PH, Raat H, Hofman A, Jaddoe VW. Risk factors and outcomes associated with firsttrimester fetal growth restriction. JAMA. 2010;303(6):527–534.

    Article  CAS  PubMed  Google Scholar 

  5. Steegers-Theunissen RP, Steegers EA. Nutrient-gene interactions in early pregnancy: a vascular hypothesis. Eur J Obstet Gynecol Reprod Biol. 2003;106(2):115–117.

    Article  CAS  PubMed  Google Scholar 

  6. Lane M, Robker RL, Robertson SA. Parenting from before conception. Science. 2014;345(6198):756–760.

    Article  CAS  PubMed  Google Scholar 

  7. Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet. 2010; 376(9754):1775–1784.

    Article  PubMed  Google Scholar 

  8. Haslam DW, James WP. Obesity. Lancet. 2005;366(9492): 1197–1209.

    Article  PubMed  Google Scholar 

  9. Collaborators GBDRF, Forouzanfar MH, Alexander L, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;386(10010):2287–2323.

    Article  Google Scholar 

  10. Gormack AA, Peek JC, Derraik JG, Gluckman PD, Young NL, Cutfield WS. Many women undergoing fertility treatment make poor lifestyle choices that may affect treatment outcome. Hum Reprod. 2015;30(7):1617–1624.

    Article  CAS  PubMed  Google Scholar 

  11. Jaddoe VW, Verburg BO, de Ridder MA, et al. Maternal smoking and fetal growth characteristics in different periods of pregnancy: the generation R study. Am J Epidemiol. 2007;165(10):1207–1215.

    Article  PubMed  Google Scholar 

  12. Lundsberg LS, Illuzzi JL, Belanger K, Triche EW, Bracken MB. Low-to-moderate prenatal alcohol consumption and the risk of selected birth outcomes: a prospective cohort study. Ann Epidemiol. 2015;25(1):46–54.e43.

    Article  PubMed  Google Scholar 

  13. Feodor Nilsson S, Andersen PK, Strandberg-Larsen K, Nybo Andersen AM. Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study. BJOG. 2014; 121(11):1375–1384.

    Article  CAS  PubMed  Google Scholar 

  14. Aliyu MH, Wilson RE, Zoorob R, et al. Alcohol consumption during pregnancy and the risk of early stillbirth among singletons. Alcohol. 2008;42(5):369–374.

    Article  CAS  PubMed  Google Scholar 

  15. Gluckman PD, Hanson MA, Cooper C, Thornburg KL. Effect of in utero and early-life conditions on adult health and disease. N Engl J Med. 2008;359(1):61–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Jaddoe VW, de Jonge LL, Hofman A, Franco OH, Steegers EA, Gaillard R. First trimester fetal growth restriction and cardiovascular risk factors in school age children: population based cohort study. BMJ. 2014;348:g14.

    Google Scholar 

  17. Steegers-Theunissen RP, Twigt J, Pestinger V, Sinclair KD. The periconceptional period, reproduction and long-term health of offspring: the importance of one-carbon metabolism. Hum Reprod Update. 2013;19(6):640–655.

    Article  CAS  PubMed  Google Scholar 

  18. Godfrey KM, Gluckman PD, Hanson MA. Developmental origins of metabolic disease: life course and intergenerational perspectives. Trends Endocrinol Metab. 2010;21(4):199–205.

    Article  CAS  PubMed  Google Scholar 

  19. Koning AHJ, Rousian M, Verwoerd-Dikkeboom CM, Goedknegt L, Steegers EAP, van der Spek PJ. V-Scope: design and implementation of an immersive and desktop virtual reality volume visualization system. Stud Health Technol Inform. 2009;142: 136–138.

    Google Scholar 

  20. Verwoerd-Dikkeboom CM, Koning AH, Hop WC, et al. Reliability of three-dimensional sonographic measurements in early pregnancy using virtual reality. Ultrasound Obst Gyn. 2008; 32(7):910–916.

    Article  CAS  Google Scholar 

  21. Verwoerd-Dikkeboom CM, Koning AHJ, Hop WC, van der Spek PJ, Exalto N, Steegers EAP. Innovative virtual reality measurements for embryonic growth and development. Hum Reprod. 2010;25(6):1404–1410.

    Article  CAS  PubMed  Google Scholar 

  22. Steegers-Theunissen RP, Verheijden-Paulissen JJ, van Uitert EM, et al. Cohort profile: the Rotterdam Periconceptional Cohort (PREDICT study). Int J Epidemiol. 2016;45(2):374–381.

    Article  PubMed  Google Scholar 

  23. Siebelink E, Geelen A, de Vries JH. Self-reported energy intake by FFQ compared with actual energy intake to maintain body weight in 516 adults. Br J Nutr. 2011;106(2):274–281.

    Article  CAS  PubMed  Google Scholar 

  24. The Netherlands Nutrition Centre. 2015. http://www.voedingscentrum.nl/Assets/Uploads/voedingscentrum/Documents/Profession als/Pers/Factsheets/Factsheet%20Voeding%20en%20zwangers chap.pdf. Accessed August 18, 2016.

  25. World Health Organization. Prevention of Neural Tube Defects. Geneva: Standards for Maternal and Neonatal Care. 2006.

    Google Scholar 

  26. van Uitert EM, van der Elst-Otte N, Wilbers JJ, et al. Periconception maternal characteristics and embryonic growth trajectories: the Rotterdam Predict Study. Hum Reprod. 2013;28(12):3188–3196.

    Article  PubMed  Google Scholar 

  27. Rousian M, Koning AH, van Oppenraaij RH, et al. An innovative virtual reality technique for automated human embryonic volume measurements. Hum Reprod. 2010;25(9):2210–2216.

    Article  CAS  PubMed  Google Scholar 

  28. Lucock M. Folic acid: nutritional biochemistry, molecular biology, and role in disease processes. Mol Genet Metab. 2000;71(1-2):121–138.

    Article  CAS  PubMed  Google Scholar 

  29. Zeisel SH. Importance of methyl donors during reproduction. Am J Clin Nutr. 2009;89(2):673S-677S.

    Google Scholar 

  30. van Uitert EM, van Ginkel S, Willemsen SP, et al. An optimal periconception maternal folate status for embryonic size: the Rotterdam Predict Study. BJOG. 2014;121(7):821–829.

    Article  PubMed  Google Scholar 

  31. Koning IV, Groenenberg IA, Gotink AW, et al. Periconception maternal folate status and human embryonic cerebellum growth trajectories: the Rotterdam Predict Study. PLoS One. 2015; 10(10):e0141089.

    Google Scholar 

  32. Refsum H, Nurk E, Smith AD, et al. The Hordaland Homocysteine Study: a community-based study of homocysteine, its determinants, and associations with disease. J Nutr. 2006;136(suppl 6):1731S–1740S.

    Google Scholar 

  33. Wang N, Tikellis G, Sun C, et al. The effect of maternal prenatal smoking and alcohol consumption on the placenta-to-birth weight ratio. Placenta. 2014;35(7):437–441.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Burd L, Roberts D, Olson M, Odendaal H. Ethanol and the placenta: a review. J Matern Fetal Neonatal Med. 2007;20(5):361–375.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, 3000 CA, the Netherlands

    Matthijs R. Van Dijk MD, Nicole V. Borggreven MSc, Sten P. Willemsen MSc, Régine P. M. Steegers-Theunissen MD, PhD & Maria P. H. Koster MD, PhD

  2. Department of Biostatistics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

    Sten P. Willemsen MSc

  3. Department of Bioinformatics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

    Anton H. J. Koning PhD

  4. Division of Neonatology, Department of Pediatrics, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands

    Régine P. M. Steegers-Theunissen MD, PhD

Authors
  1. Matthijs R. Van Dijk MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicole V. Borggreven MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sten P. Willemsen MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anton H. J. Koning PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Régine P. M. Steegers-Theunissen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria P. H. Koster MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria P. H. Koster MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Van Dijk, M.R., Borggreven, N.V., Willemsen, S.P. et al. Maternal Lifestyle Impairs Embryonic Growth: The Rotterdam Periconception Cohort. Reprod. Sci. 25, 916–922 (2018). https://doi.org/10.1177/1933719117728801

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1177/1933719117728801

Keywords

Search

Navigation