Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes

Abstract

Background While the potential adverse outcomes of prenatal exposure to unhealthy lifestyle are widely evidenced, little is known about these exposures in the periconception period. We investigated the associations between lifestyle behaviours and adverse pregnancy outcomes with a unique distinction between preconceptional- and prenatal lifestyle behaviours. Methods A secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first trimester lifestyle behaviours were assessed through a self-administered questionnaire in the first trimester. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between 2012 and 2014 and analysed using multivariate logistic regression. Results Women who are overweight, and especially obese, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95 % Confidence Interval (CI) 1.31–1.99) and aOR 2.85 (95 %CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally continued smoking attained higher odds for SGA (aOR 1.91 (95 %CI 1.05–1.15)) compared to the reference group, but these odds decreased when women prenatally quit smoking (aOR 1.14 (95 %CI 0.59–2.21)). Women who did not use folic acid supplements tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95 %CI 0.97–1.69)), while women who prenatally started folic acid supplements did not (aOR 1.01 (95 %CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a normal body mass index (BMI) and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.

Maternal supplementation with multiple micronutrients containing folic acid increased the risk for Gestational Diabetes Mellitus: Results from a prospective cohort study in China

“…These researchers considered folic acid to be a key component of the impact while neglecting the effects of other vitamins or minerals. They reported inconsistent results ranging from a protective role 19,20 of folic acid to no effect 21,22 or harmful associations [23][24][25] . The actual effect of folic acid on GDM is still unclear.…”

“…With the widespread application of folic acid supplementation, people are becoming increasingly concern about its safety and potential side effects [15][16][17][18] . Several studies have assessed the association between periconceptional folic acid supplementation (including MM-FA) and GDM, but the results were inconsistent [19][20][21][22][23][24][25] . In addition, some studies suggest a different effect between taking folic acid alone and MM-FA on the risk for adverse maternal and infant outcomes 26,27 , but few studies have explored the difference in the risk for GDM between women using folic acid alone and those using MM-FA.…”

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

“…Premature rupture of membranes (PROM): Premature rupture of membranes (PROM) is a rupture (breaking open) of the membranes (amniotic sac) before labor begins. Adverse pregnancy outcomes: women with one of the following complications, including abortion, sPTB, GDM, HDP, and PROM ( 14 ). Macrosomia: Birth weight more than 4,000 grams.…”

The effect of a locally tailored intervention on the uptake of preconception care in the Netherlands: a stepped-wedge cluster randomized trial (APROPOS-II study)

“…Since then, many health promotion initiatives have been launched focussing on the prevention and recognition of potential risk factors for adverse pregnancy outcomes, such as preterm birth and fetal growth restriction [2,3]. Analysis of the collected evidence has shown that exposure to unhealthy lifestyle behaviours before or during pregnancy, such as smoking, unhealthy nutrition, alcohol consumption and physical inactivity, negatively affect pregnancy outcomes [4][5][6]. In addition, other studies suggest that women suffering from adverse pregnancy outcomes have an increased risk for developing long-term health issues, such as obesity, type 2 diabetes and cardiovascular-and respiratory disease [7][8][9][10].…”