The impact of maternal lifestyle factors on periconception outcomes: a systematic review of observational studies

Abstract

In this systematic review of observational studies, modifiable maternal lifestyle factors were found to influence several periconception outcomes. These data further support the importance of adopting healthy lifestyles of couples planning a pregnancy to improve reproductive health. ABSTRACTThe main risk factors for important reproductive health issues such as subfertility and perinatal mortality largely originate in the periconception period. To evaluate associations between modifiable maternal lifestyle factors and periconception outcomes, a systematic search was conducted for relevant studies published from 1990 to February 2017 on Embase, Medline, Web of Science, Cochrane database, PubMed and Google Scholar. The initial search identified 6166 articles, of which 49 studies were eligible for inclusion. Fecundity (the capacity to have a live birth) showed significant inverse associations with smoking, alcohol use and poor diet. Studies regarding time to pregnancy showed a decline in fecundity ratios (the monthly conception rate among exposed relative to unexposed couples) with increasing body mass index (BMI). Furthermore, risk of first-trimester miscarriage was found to be increased in smokers, alcohol and caffeine consumers, and with increasing BMI. Vitamin supplement use showed a decrease in this risk. This review demonstrates that maternal modifiable lifestyle factors affect periconception outcomes. If couples planning a pregnancy are more aware and supported to adopt healthy lifestyles during the periconceptional 'window of opportunity', short-term reproductive health as well as health in later life and even of future generations can be further improved.

Validation of a Semi-Quantitative Food-Frequency Questionnaire for Dutch Pregnant Women from the General Population Using the Method or Triads

“…The developmental origins of health and disease (DOHaD) model proposes that differences in prenatal exposures such as maternal diet, acting at different stages of fetal development, can cause permanent developmental adaptations thereby not only affecting fetal growth but also the risk of diseases in later life [1]. Diet during pregnancy has indeed been linked to fetal growth [2][3][4][5], later child health [6][7][8], and adult chronic disease risk [9]. Maternal diet has also been associated with various congenital malformations, such as congenital heart defects, cleft defects in palate and lip, and neural tube defects [10,11].…”

Preconceptional Maternal Vegetable Intake and Paternal Smoking Are Associated with Pre-implantation Embryo Quality

“…Importantly, a Western diet with high intakes of pizza and potatoes and low intake of fruit was associated with a nearly two-fold increase in developing a congenital cleft lip [34]. In line with these findings, Oostingh et al recently reported in a review that inadequate maternal nutrition is associated with lower fecundity and that an optimal maternal vitamin status is associated with decreased risk of first-trimester miscarriage [3]. The positive associations in our study between maternal vegetables, fruits, paternal smoking, and pre-implantation embryo quality indicate that both maternal and paternal factors already influence initiation of embryo potential and development capacity directly postconceptionally.…”

“…The correlation between a maternal healthy diet and periconceptional outcomes has been well established [3]. Vujkovic et al showed that adherence to a healthy "Mediterranean" dietary pattern, which consists of high intake of vegetable oils, vegetables, fish, and legumes and low intake of snacks, is associated with an increased chance (odds ratio: 1.4) of pregnancy in couples undergoing an IVF/ICSI treatment [32].…”

Effectiveness of a therapeutic multiple-lifestyle intervention taking into account the periconceptional environment in the management of infertile couples: study design of a randomized controlled trial – the PEPCI study

“…Indeed, several studies have shown the deleterious effect of certain eating behaviours on male and female reproductive functions; for example, an insufficient intake of vegetables and fruits, cereals with sufficient fibre, foods rich in omega 3 (e.g., fatty fish, avocados), poultry, foods rich in antioxidants, and low-fat dairy products increases the risk of infertility. In addition, high rates of consumption of high-fat dairy products (cheese), potatoes, soy-based foods, red or processed meat, saturated fatty acids and sugars, coffee, and alcohol are harmful [30][31][32].…”