Periconception Epidemiology

Background

Interactions between parental conditions, environmental exposures, and genetic variations affect growth, development, plasticity, and functioning of parental gametes and (extra-) embryonic and fetal organs. Evidence is compelling that these interactions during pregnancy also contribute to obesity and other non-communicable diseases during the life course. Most reproductive failures, pregnancy complications, and adverse pregnancy outcomes originate in the periconceptional period, a time window of 14 weeks before and up to 10 weeks after conception. Therefore, we focus our research on this specific window to achieve the greatest short- and long term health benefits for both the mother, father and their (unborn) child.

Research

The research group Periconception Epidemiology investigates the influences of the maternal and paternal 1-carbon metabolism, cardiovascular and metabolic pathway and lifestyle behaviours (folic acid, nutrition, smoking, alcohol, exercise) on parental health, and embryonic and fetal development and growth, in the periconceptional period. With these findings, we developed innovative eHealth and digital interventions, such as Slimmer Zwanger (Smarterpregnancy), targeted at improving poor lifestyle factors. Slimmer Zwanger is a proven (cost-)effective interactive tailored coaching platform, which not only increases healthy behavior of participants, but also increases chances of ongoing pregnancy.

Rotterdam periconception cohort (Predict study)

A major part of our research is embedded in the Predict study, a large ongoing prospective cohort study focused on women and partner enrolled in the periconception period. This study started as a pilot and since 2010 consist of > 3000 couples and pregnancies. Here, we focus on the investigation of:

determinants of the couple’s periconceptional health;

the reproductive performance and pregnancy course and outcome;

the underlying epigenetic profiles to explain associations between periconceptional parental health, reproductive performance and pregnancy course and outcome.

International

Thus far, we have welcomed numerous scientists and students from various scientific disciplines (medicine, nutrition, biomedical sciences, epidemiology, psychology, technology, industrial design) and from all over the world. Thus far, 45 PhD students have finalized their PhD in our group and more than 200 MSc or MD projects have been completed within  the team.

Examples of previous and current projects:

• Impact of periconceptional in vitro exposures on (preimplantation) embryonal development.
• Bariatric surgery on pregnancy, embryonal and fetal growth.
• Using virtual reality and 3D imaging for investigating the development of the embryo, placenta and utero-placental vasculature.
• Impact of eHealth coaching on periconceptional maternal obesity, nutrition, lifestyle and fertility, early and late pregnancy outcomes, and maternal blood pressure.
• Ovarian health and early adaptation to pregnancy.
• Paternal lifestyle and nutrition on (preimplantation) embryo quality and development.
• Influence of maternal and paternal obesity, nutrition and lifestyle on embryonic development during IVF treatments.
• 4D fetal brain atlas using deep learning and machine learning.
• The associations between maternal telomere length and congenital malformations.
• Motivating vulnerable women for preconception care.

An overview of our publications can be found here:

• Régine Steegers-Theunissen.

Collaboration within Erasmus MC

• Epidemiology.
• Cell Biology.
• Virology.
• Medical Ethics and Philosophy.
• Clinical Chemistry.
• Internal Medicine.
• Biostatistics.
• Radiology.
• Bioinformatics.
• Paediatrics.
• Neonatology.

Collaboration outside of Erasmus MC

• TU Delft.
• Medical Delta.
• Wageningen University.
• DOHaRT network.
• Precise network.
• LifeCycle network.
• Our Smart family network (OSFB).
• Pediatric hospital network (PEHMS).

2018

• A loyalty program to motivate vulnerable women to engage in preconception care: ‘from voucher to tablet’. ZonMW Zwangerschap en Geboorte. (250K)
• Accelerated maternal ageing as pathway in the causation and prevention of neural tube defect in human. Bo Hjelt Foundation. (85K)
• Modelling the impact of maternal obesity on longitudinal prenatal human brain development using a 4-dimensional spationtemporal ultrasound atlas. MRace Grants. (150K)
• Chromosome aberrations in human pre-implantation embryos: How to use comprehensive chromosome screening to improve IVF outcome. MRace Grants. (150K)
• Zwangerschap en geboorte. Incentive-based approach to reduce risk behaviour in (potential) future parents: the SAFER pregnancy study. ZonMW. (300K, advisor)
• JPI-2018-ERA-HDHL-Nutrition and the epigenome: PREcisE - A Precision nutri-epigenetic approach to tackle the mother-to-child transmission of impaired glucose metabolism. ZonMW. (300K)
• Groei & Krimp. (539K)
• Koers 18. (155K)
• 2018 Healthy heart, healthy pregnancy? How a woman's periconceptional cardiovascular health affects the development of preeclampsia. Preeclampsia foundation. (65$)

2019

• Periconceptional programming of Health outcomes in Assisted Reproductive Technologies, Diabetes and Obesity DohArt European Cooperation in Science & Technology. (539K)
• The Medical Delta Institute of Fetal and Neonatal Care. Technology for the youngest and the smallest. Medical Delta.
• Lifecourse Zorgplatform 1.0 Erasmus MC Koers 23. (195K)
• Improving the health agency of vulnerable mother-to-be: taking empowerment seriously. ZonMw. (150K)

2020

• Feeling good, despite illness; accessible eHealth supporting the well-being of chronically ill children. The eHealth Junior Consortium. NWA. (5 million)
• Obesity during pregnancy: the mechanistic role of the microbiome in maternal and fetal complications. ZonMw, open competition. (750K)
• Business case digital Erasmus MC life course care platform. (20K)

2021

• Flagship Healthy Ageing across the life course, from bench to bedside to the society.10K.

2022

• Periconceptional programming of Health outcomes, PeriPH. COST
• Our Smart Family Buddy” Co-creative Interactive Digital Buddy platform operating by App and robot (Avatar) for young families in deprived neighbourhoods that fosters health literacy, healthy lifestyle, and healthy environments. (3,5 million).
• Strong Babies-ISSHP Jonge Onderzoekers beurs, Affiliaties: Strong Babies, Fonds gezond geboren, International society for the study of hypertension in pregnancy (ISSHP)(Eline de Vos). (10K)
• Award Sofie van Zundert. De Snoo van ’t Hoogerhuijs Foundation, senior award, “A biological signature for maternal vulnerability, and its impact on embryonic growth”. (15 k)
• Health Holland Strategic Public Private Partnership Solid Start (several supporting grants as member of the steering group).
• SSWO grant: ’A deep learning solution for congenital anomaly detection in early pregnancy’’. Samenwerking V&G met de afdeling Kinderchirurgie, de nationale foetale biobank en de Biomedical Imaging Group Rotterdam (Rousian) (300K).

2023

• Erasmus MC Research Innovation Grant: ‘’Fully automated morphology staging of the human embryo’’. Samenwerking V&G met de Biomedical Imaging Group Rotterdam (Rousian/Steegers-Theunissen) (50K).
• Convergence Health & Technology: voor het uitwerken van subsidie aanvragen voor ‘’Healthy ageing across the life course: from bench to bedside and into society (HELIOS)’’ (Rousian/Steegers-Theunissen) (23K).
• The Association between first-trimester utero-placental vascular skeleton and maternal cardiovascular adaptation to pregnancy: An Artificial Intelligence (AI) analysis. De Vos E, van Rijn B, Mulders A, Steegers-Theunissen RPM. Vrienden van Sophia. (130K)
• Rotterdam BuurtBuzz Meals on Wheels, Stift M, Zielinska S, Steegers-Theunissen RPM, Vrienden van Sophia. (70K)
• Pediatric Hospitals as European drivers for multi-party computation and synthetic data generation capabilities across clinical specialties and data types Horizon 2020-RIA. (300K)

• Régine Steegers-Theunissen, Principal Investigator.
• Elisabeth Verheus: Secretary.
• Ann Vanrolleghem, MSc: Project coordinator, data manager.
• Joke van Rhee-Binkhorst: Research nurse.
• Melek Rousian, MD, PhD: Gynaecologist, fellow, postdoc researcher.
• Sam Schoenmakers, MD, PhD: Gynaecologist, senior researcher.
• Anne-Marie Mulders, MD, PhD: Gynaecologist.
• Anton Koning, PhD: Bioinformatics.
• Sten Willemsen, PhD: Statistician.
• Ashley Smith, MSc: PhD student.
• Batoul Hojeij, MSc: PhD student.
• Damiat Alouad Fares, MD: PhD student.
• Eva van Marion, MD: PhD student.
• Eline de Vos, MD: PhD student.
• Eleonora Rubini, MSc: PhD student.
• Ferdoos Esrail, MSc, PhD student.
• Fieke Husen, MD: PhD student.
• Katinka Snoek, MD: PhD student.
• Lotte Voskamp, MD: PhD student.
• Lieske Wekema, MSc, PhD student.
• Marcella Zijta: PhD student.
• Marjolein van Vliet, MD: PhD student.
• Noa van den Brink, MSc, PhD student.
• Nicole Schenkelaars, MD: PhD student.
• Nicolien Dinklo, MSc: PhD student.
• Rosalieke Wiegel, MD: PhD student.
• Shatha Degachi, MSc: PhD student.
• Sharissa Smith, MD: PhD student.