PhD defence S.K.M. (Sofie) Wahlbrinck - van Zundert

Brief summary:

During the periconception period critical developmental processes occur, which are sensitive for maternal health and environmental exposures. Exposure to maternal risks (stressors) during the periconception period can impair early development of the embryo and placenta. This can have long-term effects on the health of the mother, child, and even of future generations. Women exposed to accumulation of these risk factors (vulnerability markers) are considered vulnerable, and have an increased risk of adverse maternal and pregnancy outcomes. To date, the exact underlying biological mechanisms have not completely been elucidated yet. Gaining more insight into these biological mechanisms and their impact on periconceptional health, may provide targets for early identification of women in vulnerable situations, and for prevention of adverse pregnancy outcomes. In this thesis, the tryptophan metabolism and the chronic stress response are proposed as potential biological mechanisms through which maternal vulnerability exerts its detrimental health effects. In order to reduce health inequity during the early life course, interventions aimed at optimizing periconceptional health are required. Lifestyle interventions targeting preconceptional and pregnant women can enhance lifestyle behaviours, and thereby improve health of the mother and child during and beyond pregnancy. These interventions should be personalised, context-specific and life course phased to maximise health benefits for current and future generations. The epidemiological studies in this thesis have been performed within The Rotterdam Periconceptional Cohort (Predict Study), which is an ongoing prospective tertiary hospitalbased cohort study, including more than 2000 pregnancies.