Journal articles: 'Periconception period'

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Fazeli, Alireza, and William V. Holt. "Cross talk during the periconception period." Theriogenology 86, no. 1 (July 2016): 438–42. http://dx.doi.org/10.1016/j.theriogenology.2016.04.059.

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Schelbach, Cheryl J., Rebecca L. Robker, Brenton D. Bennett, Ashley D. Gauld, Jeremy G. Thompson, and Karen L. Kind. "Altered pregnancy outcomes in mice following treatment with the hyperglycaemia mimetic, glucosamine, during the periconception period." Reproduction, Fertility and Development 25, no. 2 (2013): 405. http://dx.doi.org/10.1071/rd11313.

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Exposure of cumulus–oocyte complexes to the hyperglycaemia mimetic, glucosamine, during in vitro maturation impairs embryo development, potentially through upregulation of the hexosamine biosynthesis pathway. This study examined the effects of in vivo periconception glucosamine exposure on reproductive outcomes in young healthy mice, and further assessed the effects in overweight mice fed a high-fat diet. Eight-week-old mice received daily glucosamine injections (20 or 400 mg kg–1) for 3–6 days before and 1 day after mating (periconception). Outcomes were assessed at Day 18 of gestation. Glucosamine treatment reduced litter size independent of dose. A high-fat diet (21% fat) for 11 weeks before and during pregnancy reduced fetal size. No additional effects of periconception glucosamine (20 mg kg–1) on pregnancy outcomes were observed in fat-fed mice. In 16-week-old mice fed the control diet, glucosamine treatment reduced fetal weight and increased congenital abnormalities, but did not alter litter size. As differing effects of glucosamine were observed in 8-week-old and 16-week-old mice, maternal age effects were assessed. Periconception glucosamine at 8 weeks reduced litter size, whereas glucosamine at 16 weeks reduced fetal size. Thus, in vivo periconception glucosamine exposure perturbs reproductive outcomes in mice, with the nature of the outcomes dependent upon maternal age.

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Rajila Rajendran, Hannah Sugirthabai, Thotakura Balaji, Jyothi Ashok Kumar, Santhosh Kumar, and Vaithianathan Gnanasundaram. "Folic Acid Supplementation on Fetal Growth at Different Gestational Ages." Biomedical and Pharmacology Journal 14, no. 4 (December 30, 2021): 1761–66. http://dx.doi.org/10.13005/bpj/2275.

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Introduction: Folate, Vitamin B9, is found naturally in our day to day foods. It is vital for synthesis of DNA and normal cell division in humans. Studies have revealed constantly that maternal folic acid[FA] intake prior to and in early conception decreases neural tube defects. Aim: The aim of the current study is to evaluate the relationship between FA intake by the mother during conception and fetal growth at different gestational ages and also if, periconceptional and preconceptional FA intake has a positive effect on fetal growth, hence reducing the risk of low birth weight babies or small for gestational age (SGA) babies. Materials and methods: 180 pregnant women were classified based on their period of FA intake as preconception, periconception FA intake and nil FA intake. Standard fetal biometric parameters were measured using ultrasonogram during the 1st , 2nd and 3rd trimester of their pregnancy. Results: Preconception FA intake had a positive effect on fetal growth as compared to those who abstained from FA supplementation. Intake during preconception and peri-conception i.e. immediately after confirmation of pregnancy was found to have a reduced risk of low fetal weight as against those who did not consume FA. Fetal biometry showed significant difference between preconception and periconception groups. Conclusion: In conclusion, preconceptional and periconceptional FA supplementation of 0.4-0.5 mg/day was positively affecting fetal growth and caused an optimal birth weight by decreasing the incidence of low birth weight.

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Matusiak, Kristine, Helen L. Barrett, Leonie K. Callaway, and Marloes Dekker Nitert. "Periconception Weight Loss: Common Sense for Mothers, but What about for Babies?" Journal of Obesity 2014 (2014): 1–10. http://dx.doi.org/10.1155/2014/204295.

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Obesity in the childbearing population is increasingly common. Obesity is associated with increased risk for a number of maternal and neonatal pregnancy complications. Some of these complications, such as gestational diabetes, are risk factors for long-term disease in both mother and baby. While clinical practice guidelines advocate for healthy weight prior to pregnancy, there is not a clear directive for achieving healthy weight before conception. There are known benefits to even moderate weight loss prior to pregnancy, but there are potential adverse effects of restricted nutrition during the periconceptional period. Epidemiological and animal studies point to differences in offspring conceived during a time of maternal nutritional restriction. These include changes in hypothalamic-pituitary-adrenal axis function, body composition, glucose metabolism, and cardiovascular function. The periconceptional period is therefore believed to play an important role in programming offspring physiological function and is sensitive to nutritional insult. This review summarizes the evidence to date for offspring programming as a result of maternal periconception weight loss. Further research is needed in humans to clearly identify benefits and potential risks of losing weight in the months before conceiving. This may then inform us of clinical practice guidelines for optimal approaches to achieving a healthy weight before pregnancy.

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Timmermans, Sarah, Vincent W. V. Jaddoe, Albert Hofman, Régine P. M. Steegers-Theunissen, and Eric A. P. Steegers. "Periconception folic acid supplementation, fetal growth and the risks of low birth weight and preterm birth: the Generation R Study." British Journal of Nutrition 102, no. 5 (September 14, 2009): 777–85. http://dx.doi.org/10.1017/s0007114509288994.

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Countries worldwide, including the Netherlands, recommend that women planning pregnancy use a folic acid supplement during the periconception period. Some countries even fortify staple foods with folic acid. These recommendations mainly focus on the prevention of neural tube defects, despite increasing evidence that folic acid may also influence birth weight. We examined whether periconception folic acid supplementation affects fetal growth and the risks of low birth weight, small for gestational age (SGA) and preterm birth, in the Generation R Study in Rotterdam, the Netherlands. Main outcome measures were fetal growth measured in mid- and late pregnancy by ultrasound, birth weight, SGA and preterm birth in relation to periconception folic supplementation (0·4–0·5 mg). Data on 6353 pregnancies were available. Periconception folic acid supplementation was positively associated with fetal growth. Preconception folic acid supplementation was associated with 68 g higher birth weight (95 % CI 37·2, 99·0) and 13 g higher placental weight (95 % CI 1·1, 25·5), compared to no folic acid supplementation. In these analyses parity significantly modified the effect estimates. Start of folic acid supplementation after pregnancy confirmation was associated with a reduced risk of low birth weight (OR 0·61, 95 % CI 0·40, 0·94). Similarly, reduced risks for low birth weight and SGA were observed for women who started supplementation preconceptionally, compared to those who did not use folic acid (OR 0·43, 95 % CI 0·28, 0·69 and OR 0·40, 95 % CI 0·22, 0·72). In conclusion, periconception folic acid supplementation is associated with increased fetal growth resulting in higher placental and birth weight, and decreased risks of low birth weight and SGA.

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González-Brusi, Leopoldo, Blanca Algarra, Carla Moros-Nicolás, Mª José Izquierdo-Rico, Manuel Avilés, and Maria Jiménez-Movilla. "A Comparative View on the Oviductal Environment during the Periconception Period." Biomolecules 10, no. 12 (December 17, 2020): 1690. http://dx.doi.org/10.3390/biom10121690.

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The oviduct plays important roles in reproductive events: sperm reservoir formation, final gamete maturation, fertilization and early embryo development. It is well known that the oviductal environment affects gametes and embryos and, ultimately, the health of offspring, so that in vivo embryos are better in terms of morphology, cryotolerance, pregnancy rates or epigenetic profile than those obtained in vitro. The deciphering of embryo–maternal interaction in the oviduct may provide a better understanding of the embryo needs during the periconception period to improve reproductive efficiency. Here, we perform a comparative analysis among species of oviductal gene expression related to embryonic development during its journey through the oviduct, as described to date. Cross-talk communication between the oviduct environment and embryo will be studied by analyses of the secreted or exosomal proteins of the oviduct and the presence of receptors in the membrane of the embryo blastomeres. Finally, we review the data that are available to date on the expression and characterization of the most abundant protein in the oviduct, oviductin (OVGP1), highlighting its fundamental role in fertilization and embryonic development.

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van der Windt, Melissa, Rianne Maria van der Kleij, Katinka Marianne Snoek, Sten Paul Willemsen, Ramon Henny Maria Dykgraaf, Joop Stephanus Elisabeth Laven, Sam Schoenmakers, and Régine Patricia Maria Steegers-Theunissen. "Impact of a Blended Periconception Lifestyle Care Approach on Lifestyle Behaviors: Before-and-After Study." Journal of Medical Internet Research 22, no. 9 (September 30, 2020): e19378. http://dx.doi.org/10.2196/19378.

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Background Periconception lifestyle behaviors affect maternal, paternal, offspring, and transgenerational health outcomes. Previous research in other target populations has shown that personalized lifestyle interventions, in which face-to-face counseling and eHealth (“blended care”) are combined, may effectively target these lifestyle behaviors. Objective We aimed to assess the effectiveness of a periconceptional lifestyle intervention on the improvement of specific lifestyle components. Methods A blended periconception lifestyle care approach was developed, combining the outpatient lifestyle counseling service “Healthy Pregnancy” with the eHealth platform “Smarter Pregnancy” (www.smarterpregnancy.co.uk) in which lifestyle was coached for 24 weeks. All couples contemplating pregnancy or already pregnant (≤12 weeks of gestation) who visited the outpatient clinics of the Department of Obstetrics and Gynecology at the Erasmus University Medical Center (Erasmus MC), Rotterdam, the Netherlands, between June and December 2018, were invited to participate. We measured changes in lifestyle behaviors at weeks 12 and 24 compared with baseline. Generalized estimating equations were used to analyze the changes in lifestyle behaviors over time. Subgroup analyses were performed for women with obesity (BMI ≥30 kg/m2), women pregnant at the start of the intervention, and those participating as a couple. Results A total of 539 women were screened for eligibility, and 450 women and 61 men received the blended periconception intervention. Among the participating women, 58.4% (263/450) were included in the preconception period. Moreover, 78.9% (403/511) of the included participants completed the online lifestyle coaching. At baseline, at least one poor lifestyle behavior was present in most women (379/450, 84.2%) and men (58/61, 95.1%). In the total group, median fruit intake increased from 1.8 to 2.2 pieces/day (P<.001) and median vegetable intake increased from 151 to 165 grams/day (P<.001) after 24 weeks of online coaching. The probability of taking folic acid supplementation among women increased from 0.97 to 1 (P<.001), and the probability of consuming alcohol and using tobacco in the total group decreased from 0.25 to 0.19 (P=.002) and from 0.20 to 0.15 (P=.63), respectively. Overall, the program showed the strongest effectiveness for participating couples. Particularly for vegetable and fruit intake, their consumption increased from 158 grams/day and 1.8 pieces/day at baseline to 190 grams/day and 2.7 pieces/day at the end of the intervention, respectively. Conclusions We succeeded in including most participating women in the preconception period. A high compliance rate was achieved and users demonstrated improvements in several lifestyle components. The blended periconception lifestyle care approach seems to be an effective method to improve lifestyle behaviors. The next step is to further disseminate this approach and to perform a randomized trial to compare the use of blended care with the provision of only eHealth. Additionally, the clinical relevance of these results will need to be substantiated further.

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Mamon, Mark Anthony C., Cheska May M. Menodiado, Glenn L. Siasu, and Gliceria B. Ramos. "Selenium supplementation within the periconception period: Influence on maternal liver and renal histoarchitecture." Asian Pacific Journal of Reproduction 5, no. 4 (July 2016): 295–300. http://dx.doi.org/10.1016/j.apjr.2016.06.014.

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Lassi, Zohra S., Sophie G. E. Kedzior, Wajeeha Tariq, Yamna Jadoon, Jai K. Das, and Zulfiqar A. Bhutta. "Effects of Preconception Care and Periconception Interventions on Maternal Nutritional Status and Birth Outcomes in Low- and Middle-Income Countries: A Systematic Review." Nutrients 12, no. 3 (February 26, 2020): 606. http://dx.doi.org/10.3390/nu12030606.

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Pregnancy in adolescence and malnutrition are common challenges in low- and middle-income countries (LMICs), and are associated with many complications and comorbidities. The preconception period is an ideal period for intervention as a preventative tactic for teenage pregnancy, and to increase micronutrient supplementation prior to conception. Over twenty databases and websites were searched and 45 randomized controlled trials (RCTs) or quasi-experimental interventions with intent to delay the age at first pregnancy (n = 26), to optimize inter-pregnancy intervals (n = 4), and supplementation of folic acid (n = 5) or a combination of iron and folic acid (n = 10) during the periconception period were included. The review found that educational interventions to delay the age at first pregnancy and optimizing inter-pregnancy intervals significantly improved the uptake of contraception use (RR = 1.71, 95% CI = 1.42–2.05; two studies, n = 911; I2 = 0%) and (RR = 2.25, 95% CI = 1.29–3.93; one study, n = 338), respectively. For periconceptional folic acid supplementation, the incidence of neural tube defects were reduced (RR = 0.53; 95% CI = 0.41–0.77; two studies, n = 248,056; I2 = 0%), and iron-folic acid supplementation improved the rates of anemia (RR = 0.66, 95% CI = 0.53–0.81; six studies; n = 3430, I2 = 88%), particularly when supplemented weekly and in a school setting. Notwithstanding the findings, more robust RCTs are required from LMICs to further support the evidence.

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van Zundert, Sofie, Simone van der Padt, Sten Willemsen, Melek Rousian, Mina Mirzaian, Ron van Schaik, Régine Steegers-Theunissen, and Lenie van Rossem. "Periconceptional Maternal Protein Intake from Animal and Plant Sources and the Impact on Early and Late Prenatal Growth and Birthweight: The Rotterdam Periconceptional Cohort." Nutrients 14, no. 24 (December 14, 2022): 5309. http://dx.doi.org/10.3390/nu14245309.

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Plant-based diets continue to rise in popularity, including among women of reproductive age, while consequences for pregnancy outcomes have hardly been studied. During pregnancy, maternal diet is the only source of proteins for the developing fetus. Hence, we investigated the effects of periconceptional maternal animal and plant protein intake on prenatal growth and birthweight. 501 pregnancies were included from the prospective Rotterdam Periconceptional Cohort. Embryonic growth was depicted by crown-rump length (CRL) and embryonic volume (EV) at 7, 9 and 11 weeks using 3D ultrasound scans. Estimated fetal weight (EFW) at 20 weeks and birthweight were retrieved from medical records and standardized. Multivariable mixed models were used for CRL and EV trajectories, and linear regression for EFW and birthweight. A 10 g/day higher maternal animal protein intake was positively associated with increased embryonic growth (CRL: β = 0.023 √mm, p = 0.052; EV: β = 0.015 ∛cm, p = 0.012). A positive association, albeit non-significant, was found between maternal animal protein intake and EFW, and birthweight. No clear associations emerged between maternal plant protein intake and prenatal growth and birthweight, with effect estimates close to zero. In conclusion, maternal animal protein intake during the periconception period was positively associated with early and late prenatal growth and birthweight, while no associations were found between maternal plant protein intake and prenatal growth and birthweight.

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Bhide, Prajkta, and Anita Kar. "Prevalence and determinants of folate deficiency among urban Indian women in the periconception period." European Journal of Clinical Nutrition 73, no. 12 (July 19, 2018): 1639–41. http://dx.doi.org/10.1038/s41430-018-0255-2.

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Dejmek, J., J. Malová, and J. Vojtaššák. "Alcohol use and smoking during the periconception period and developmental anomalies in aborted fetuses." Mutation Research/Environmental Mutagenesis and Related Subjects 271, no. 2 (1992): 199–200. http://dx.doi.org/10.1016/0165-1161(92)91289-4.

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Ersbøll, Anne S., Mette Hedegaard, Peter Damm, Marianne Johansen, Ann Tabor, and Hanne K. Hegaard. "Changes in the pattern of paracetamol use in the periconception period in a Danish cohort." Acta Obstetricia et Gynecologica Scandinavica 94, no. 8 (May 29, 2015): 898–903. http://dx.doi.org/10.1111/aogs.12667.

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Schröder-Heurich, Bianca, Clara Juliane Pacifica Springer, and Frauke von Versen-Höynck. "Vitamin D Effects on the Immune System from Periconception through Pregnancy." Nutrients 12, no. 5 (May 15, 2020): 1432. http://dx.doi.org/10.3390/nu12051432.

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Vitamin D is a well-known secosteroid and guardian of bone health and calcium homeostasis. Studies on its role in immunomodulatory functions have expanded its field in recent years. In addition to its impact on human physiology, vitamin D influences the differentiation and proliferation of immune system modulators, interleukin expression and antimicrobial responses. Furthermore, it has been shown that vitamin D is synthesized in female reproductive tissues and, by modulating the immune system, affects the periconception period and reproductive outcomes. B cells, T cells, macrophages and dendritic cells can all synthesize active vitamin D and are involved in processes which occur from fertilization, implantation and maintenance of pregnancy. Components of vitamin D synthesis are expressed in the ovary, decidua, endometrium and placenta. An inadequate vitamin D level has been associated with recurrent implantation failure and pregnancy loss and is associated with pregnancy-related disorders like preeclampsia. This paper reviews the most important data on immunomodulatory vitamin D effects in relation to the immune system from periconception to pregnancy and provides an insight into the possible consequences of vitamin D deficiency before and during pregnancy.

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Steegers-Theunissen, Régine P. M., and Eric A. P. Steegers. "Embryonic health: new insights, mHealth and personalised patient care." Reproduction, Fertility and Development 27, no. 4 (2015): 712. http://dx.doi.org/10.1071/rd14386.

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The worldwide epidemic of non-communicable diseases (NCD), including obesity, is a burden to which poor lifestyles contribute significantly. Events in early life may enhance susceptibility to NCD, with transmission into succeeding generations. This may also explain, in part, why interventions in adulthood are less effective to reduce NCD risk. New insights reveal that the early embryo, in particular, is extremely sensitive to signals from gametes, trophoblastic tissue and periconception maternal lifestyles. Embryonic size and growth as determinants of embryonic health seem to impact future health. A relatively small embryo for gestational age is associated with pregnancy complications, as well as with the risk of early features of NCD in childhood. Although personal lifestyles are modifiable, they are extremely difficult to change. Therefore, adopting a life course approach from the periconception period onwards and integrated into patient care with short-term reproductive health benefits may have important implications for future prevention of NCD. The current reproductive population is used to Internet and social media. Therefore, they can be reached via mobile phone (mHealth) platforms that provide personalised lifestyle (pre)pregnancy programs. This will offer opportunities and possibly great benefits for the health of current and succeeding generations.

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Cha, Eun-Hwan, NaeRy Kim, Ho-Seok Kwak, Hae Ji Han, Sung Hong Joo, June-Seek Choi, Kyoung-Chul Chun, Young-Ah Kim, Jae-Whoan Koh, and Jung Yeol Han. "Pregnancy and neonatal outcomes after periconceptional exposure to isotretinoin in Koreans." Obstetrics & Gynecology Science 65, no. 2 (March 15, 2022): 166–75. http://dx.doi.org/10.5468/ogs.21354.

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ObjectiveIsotretinoin should not be used during pregnancy because of the risk of birth defects. Most pregnant women exposed to isotretinoin choose voluntary pregnancy termination due to concerns about birth defects. However, birth outcome data supporting the termination of pregnancy are lacking. This study aimed to evaluate pregnancy and neonatal outcomes after periconception exposure to isotretinoin.MethodsThis was a prospective cohort study. We evaluated pregnancy and neonatal outcomes after exposure to isotretinoin in 151 pregnant women. Among 1,026 callers at the Korean Teratology Information Service from 2001 to 2017 exposed to isotretinoin during the periconception period, 151 pregnant women who received counseling on teratogenic risk after visiting the clinic were included.ResultsAmong the 151 participants who visited the clinic, only 42 were evaluated using ultrasonography until approximately 20 weeks of gestation. Ultimately, 23 patients were included in the study. The average gestation period during the last exposure to the drug was 2 weeks, and the average daily exposure dose was 12 mg. There were two cases of major birth defects in the exposure group. Spontaneous abortion rates were 17.7% and 8.7% in the exposure and nonexposure groups, respectively (P=0.035). There was no significant difference between the exposure and non-exposure groups in terms of pregnancy and neonatal outcomes.ConclusionThere was no significant difference in pregnancy and neonatal outcomes, including birth defects, between the exposure and non-exposure groups. Further studies with larger sample sizes are required to validate our findings.

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Fleming, Tom P., Adam J. Watkins, Congshan Sun, Miguel A. Velazquez, Neil R. Smyth, and Judith J. Eckert. "Do little embryos make big decisions? How maternal dietary protein restriction can permanently change an embryo’s potential, affecting adult health." Reproduction, Fertility and Development 27, no. 4 (2015): 684. http://dx.doi.org/10.1071/rd14455.

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Periconceptional environment may influence embryo development, ultimately affecting adult health. Here, we review the rodent model of maternal low-protein diet specifically during the preimplantation period (Emb-LPD) with normal nutrition during subsequent gestation and postnatally. This model, studied mainly in the mouse, leads to cardiovascular, metabolic and behavioural disease in adult offspring, with females more susceptible. We evaluate the sequence of events from diet administration that may lead to adult disease. Emb-LPD changes maternal serum and/or uterine fluid metabolite composition, notably with reduced insulin and branched-chain amino acids. This is sensed by blastocysts through reduced mammalian target of rapamycin complex 1 signalling. Embryos respond by permanently changing the pattern of development of their extra-embryonic lineages, trophectoderm and primitive endoderm, to enhance maternal nutrient retrieval during subsequent gestation. These compensatory changes include stimulation in proliferation, endocytosis and cellular motility, and epigenetic mechanisms underlying them are being identified. Collectively, these responses act to protect fetal growth and likely contribute to offspring competitive fitness. However, the resulting growth adversely affects long-term health because perinatal weight positively correlates with adult disease risk. We argue that periconception environmental responses reflect developmental plasticity and ‘decisions’ made by embryos to optimise their own development, but with lasting consequences.

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Mamon, Mark Anthony, and Gliceria Ramos. "Selenium-supplementation at varying stages of periconception period: influence on murine blastocyst morphology and implantation status." Mechanisms of Development 145 (July 2017): S131. http://dx.doi.org/10.1016/j.mod.2017.04.363.

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Monoarfa, Yustiyanty, Erry Gumilar, Lucy Widasari, Rahayu Yekti, Anang S. Otoluwa, and Abd Razak Thaha. "The effect of selenium and multiple micronutrient administration during periconception period on the level of malondialdehyde." Enfermería Clínica 30 (June 2020): 114–18. http://dx.doi.org/10.1016/j.enfcli.2019.10.053.

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Kalisch-Smith, J. I., and K. M. Moritz. "Detrimental effects of alcohol exposure around conception: putative mechanisms." Biochemistry and Cell Biology 96, no. 2 (April 2018): 107–16. http://dx.doi.org/10.1139/bcb-2017-0133.

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In western countries, alcohol consumption is widespread in women of reproductive age, and in binge quantities. These countries also continue to have high incidences of unplanned pregnancies, with women often reported to cease drinking after discovering their pregnancy. This suggests the early embryo may be highly exposed to the detrimental effects of alcohol during the periconception period. The periconception and pre-implantation windows, which include maturation of the oocyte, fertilisation, and morphogenesis of the pre-implantation embryo, are particularly sensitive times of development. Within the oviduct and uterus, the embryo is exposed to a unique nutritional environment to facilitate its development and establish de-novo expression of the genome through epigenetic reprogramming. Alcohol has wide-ranging effects on cellular stress, as well as hormonal, and nutrient signalling pathways, which may affect the development and metabolism of the early embryo. In this review, we summarise the adverse developmental outcomes of early exposure to alcohol (prior to implantation in animal models) and discuss the potential mechanisms for these outcomes that may occur within the protected oviductal and uterine environment. One interesting candidate is reduced retinoic acid synthesis, as it is implicated in the control of epigenetic reprogramming and cell lineage commitment, processes that have adverse consequences for the formation of the placenta, and subsequently, fetal programming.

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Klein, Ari Z., Karen O'Connor, and Graciela Gonzalez-Hernandez. "Toward Using Twitter Data to Monitor COVID-19 Vaccine Safety in Pregnancy: Proof-of-Concept Study of Cohort Identification." JMIR Formative Research 6, no. 1 (January 6, 2022): e33792. http://dx.doi.org/10.2196/33792.

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Background COVID-19 during pregnancy is associated with an increased risk of maternal death, intensive care unit admission, and preterm birth; however, many people who are pregnant refuse to receive COVID-19 vaccination because of a lack of safety data. Objective The objective of this preliminary study was to assess whether Twitter data could be used to identify a cohort for epidemiologic studies of COVID-19 vaccination in pregnancy. Specifically, we examined whether it is possible to identify users who have reported (1) that they received COVID-19 vaccination during pregnancy or the periconception period, and (2) their pregnancy outcomes. Methods We developed regular expressions to search for reports of COVID-19 vaccination in a large collection of tweets posted through the beginning of July 2021 by users who have announced their pregnancy on Twitter. To help determine if users were vaccinated during pregnancy, we drew upon a natural language processing (NLP) tool that estimates the timeframe of the prenatal period. For users who posted tweets with a timestamp indicating they were vaccinated during pregnancy, we drew upon additional NLP tools to help identify tweets that reported their pregnancy outcomes. Results We manually verified the content of tweets detected automatically, identifying 150 users who reported on Twitter that they received at least one dose of COVID-19 vaccination during pregnancy or the periconception period. We manually verified at least one reported outcome for 45 of the 60 (75%) completed pregnancies. Conclusions Given the limited availability of data on COVID-19 vaccine safety in pregnancy, Twitter can be a complementary resource for potentially increasing the acceptance of COVID-19 vaccination in pregnant populations. The results of this preliminary study justify the development of scalable methods to identify a larger cohort for epidemiologic studies.

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Chavatte-Palmer, Pascale, Anne Tarrade, Hélène Kiefer, Véronique Duranthon, and Hélène Jammes. "Breeding animals for quality products: not only genetics." Reproduction, Fertility and Development 28, no. 2 (2016): 94. http://dx.doi.org/10.1071/rd15353.

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The effect of the Developmental Origins of Health and Disease on the spread of non-communicable diseases is recognised by world agencies such as the United Nations and the World Health Organization. Early environmental effects on offspring phenotype also apply to domestic animals and their production traits. Herein, we show that maternal nutrition not only throughout pregnancy, but also in the periconception period can affect offspring phenotype through modifications of gametes, embryos and placental function. Because epigenetic mechanisms are key processes in mediating these effects, we propose that the study of epigenetic marks in gametes may provide additional information for domestic animal selection.

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Schlagenhauf, P., W. A. Blumentals, P. Suter, L. Regep, G. Vital-Durand, M. T. Schaerer, M. S. Boutros, H. G. Rhein, and M. Adamcova. "Pregnancy and Fetal Outcomes After Exposure to Mefloquine in the Pre- and Periconception Period and During Pregnancy." Clinical Infectious Diseases 54, no. 11 (April 10, 2012): e124-e131. http://dx.doi.org/10.1093/cid/cis215.

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Matthews, Lynn T., Manjeetha Jaggernath, Yolandie Kriel, Patricia M. Smith, Kasey O’Neil, Jessica E. Haberer, Craig Hendrix, et al. "Protocol for a longitudinal study to evaluate the use of tenofovir-based PrEP for safer conception and pregnancy among women in South Africa." BMJ Open 9, no. 7 (July 2019): e027227. http://dx.doi.org/10.1136/bmjopen-2018-027227.

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IntroductionWomen who choose to conceive a baby with a partner living with HIV or a partner whose HIV serostatus is unknown in HIV-endemic settings need prevention strategies to mitigate HIV acquisition during conception and pregnancy.Methods and analysisWe are conducting a single-arm longitudinal study offering oral tenofovirdisoproxil fumarate/emtricitabine (TDF/FTC) as pre-exposure prophylaxis (PrEP) for periconception use to 350 HIV-uninfected women in KwaZulu-Natal, South Africa. PrEP is offered as part of woman-centred safer conception programme that promotes couples-based HIV counselling and testing, antiretroviral therapy for partners who are HIV-infected, treatment for sexually transmitted infections and safer conception strategies, such as limiting condomless sex to peak fertility. We enrol HIV-uninfected women who are not currently pregnant, in a stable relationship (≥6 months) with a partner living with HIV or of unknown serostatus, and personal or partner plans for pregnancy in the next 12 months. We follow enrolled women for 12 months. Women who become pregnant are followed through pregnancy outcome, independent of their decisions regarding PrEP use. The primary objective of the study is to evaluate the uptake of and adherence to PrEP during the periconception period and pregnancy. Secondary outcomes include the uptake of other safer conception strategies. We also measure clinical outcomes including HIV seroconversion rates and pregnancy and infant outcomes. Finally, we will explore conduct and evaluate qualitative interviews in 25 participants to further inform our conceptual framework for periconception PrEP uptake and adherence among HIV-exposed women in South Africa.Ethics and disseminationThe protocol has been approved by the Human Research Ethics Committee at the University of the Witwatersrand (Johannesburg, South Africa) and the Institutional Review Board of Partners Healthcare (Boston, Massachusetts, USA). Study findings will be made available to interested participants. Results will be presented to local health officials and stakeholders at meetings. Investigators will share the results at meetings and in manuscripts. De-identified quantitative data will be made available.Trial registration numberThe protocol is registered with the South African Health Products Regulatory Agency (SAHPRA, formerly known as the Medicine Controls Council, MCC#20170131) and ClinicalTrials.gov (NCT03194308); Pre-results.

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Maloney, C. A., S. M. Hay, and W. D. Rees. "3C-6 Insulin resistance is programmed in the periconception period by a maternal diet deficient in methyl donors." Early Human Development 83 (September 2007): S62. http://dx.doi.org/10.1016/s0378-3782(07)70103-2.

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Davidson, Lena, Silvia P. Canelón, and Mary Regina Boland. "Medication-Wide Association Study Using Electronic Health Record Data of Prescription Medication Exposure and Multifetal Pregnancies: Retrospective Study." JMIR Medical Informatics 10, no. 6 (June 7, 2022): e32229. http://dx.doi.org/10.2196/32229.

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Background Medication-wide association studies (MWAS) have been applied to assess the risk of individual prescription use and a wide range of health outcomes, including cancer, acute myocardial infarction, acute liver failure, acute renal failure, and upper gastrointestinal ulcers. Current literature on the use of preconception and periconception medication and its association with the risk of multiple gestation pregnancies (eg, monozygotic and dizygotic) is largely based on assisted reproductive technology (ART) cohorts. However, among non-ART pregnancies, it is unknown whether other medications increase the risk of multifetal pregnancies. Objective This study aimed to investigate the risk of multiple gestational births (eg, twins and triplets) following preconception and periconception exposure to prescription medications in patients who delivered at Penn Medicine. Methods We used electronic health record data between 2010 and 2017 on patients who delivered babies at Penn Medicine, a health care system in the Greater Philadelphia area. We explored 3 logistic regression models: model 1 (no adjustment); model 2 (adjustment for maternal age); and model 3—our final logistic regression model (adjustment for maternal age, ART use, and infertility diagnosis). In all models, multiple births (MBs) were our outcome of interest (binary outcome), and each medication was assessed separately as a binary variable. To assess our MWAS model performance, we defined ART medications as our gold standard, given that these medications are known to increase the risk of MB. Results Of the 63,334 distinct deliveries in our cohort, only 1877 pregnancies (2.96%) were prescribed any medication during the preconception and first trimester period. Of the 123 medications prescribed, we found 26 (21.1%) medications associated with MB (using nominal P values) and 10 (8.1%) medications associated with MB (using Bonferroni adjustment) in fully adjusted model 3. We found that our model 3 algorithm had an accuracy of 85% (using nominal P values) and 89% (using Bonferroni-adjusted P values). Conclusions Our work demonstrates the opportunities in applying the MWAS approach with electronic health record data to explore associations between preconception and periconception medication exposure and the risk of MB while identifying novel candidate medications for further study. Overall, we found 3 novel medications linked with MB that could be explored in further work; this demonstrates the potential of our method to be used for hypothesis generation.

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Goldie, J., J. Bold, and D. Haigney. "P13 Diet and nutrition in the periconception period of a subsequent pregnancy following a congenital heart defect-affected pregnancy." Heart 102, Suppl 1 (March 2016): A7.1—A7. http://dx.doi.org/10.1136/heartjnl-2016-309377.13.

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Pietersma, C. S., A. G. M. G. J. Mulders, A. Sabanovic, S. P. Willemsen, M. S. Jansen, E. A. P. Steegers, R. P. M. Steegers-Theunissen, and M. Rousian. "The impact of maternal smoking on embryonic morphological development: the Rotterdam Periconception Cohort." Human Reproduction 37, no. 4 (February 23, 2022): 696–707. http://dx.doi.org/10.1093/humrep/deac018.

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Abstract STUDY QUESTION Is periconceptional maternal smoking associated with embryonic morphological development in ongoing pregnancies? SUMMARY ANSWER Smoking during the periconceptional period is associated with a delayed embryonic morphological development which is not fully recuperated beyond the first trimester of pregnancy. WHAT IS KNOWN ALREADY Smoking during pregnancy decreases prenatal growth, increasing the risk of preterm birth, small for gestational age (GA) and childhood obesity. STUDY DESIGN, SIZE, DURATION Between 2010 and 2018, 689 women with ongoing singleton pregnancies were periconceptionally enrolled in a prospective cohort study with follow-up until 1 year after delivery. PARTICIPANTS/MATERIALS, SETTING, METHODS Between 7 + 0 and 10 + 3 weeks, GA serial three-dimensional transvaginal ultrasound scans were performed. Embryonic morphological development as assessed by the Carnegie developmental stages was evaluated using Virtual Reality techniques. In the absence of fetal morphology classification methods beyond the embryonic period, fetal ultrasound measurements at around 20 weeks’ GA, and birth weight were used to assess fetal growth. Linear mixed models were used to evaluate the association between smoking and the Carnegie stages. Regarding first-trimester morphological development, we additionally stratified our findings for mode of conception. Multiple linear regression models were used to study the association between smoking, fetal growth and birth weight. To investigate to which extent delayed embryonic morphological development mediated the effect of smoking, contemporary mediation analysis was used. Adjustments were made for potential confounders and other covariates. MAIN RESULTS AND THE ROLE OF CHANCE A total of 689 singleton ongoing pregnancies were included and 1210 Carnegie stages were determined. Maternal periconceptional smoking represented by the number of cigarettes/day was associated with a slight non-significant delay of the Carnegie stages (βcigarettes/day = −0.058, 95% CI −0.122; 0.007, P = 0.080). Smoking of ≥10 cigarettes/day showed the strongest association (β≥10 cigarettes/day = −0.352, 95% CI −0.648; −0.057, P = 0.019), as reflected by a 0.9-day delay in reaching the final Carnegie stage. Stratification for mode of conception showed a stronger negative association between the number of cigarettes/day in the IVF/ICSI group (βcigarettes/day = −0.126, 95% CI −0.200; −0.051, P = 0.001) compared to naturally conceived pregnancies (βcigarettes/day = 0.009, 95% CI −0.093; 0.111, P = 0.867). In the IVF/ICSI group, periconceptional smoking of ≥10 cigarettes/day was associated with in a 1.6 day delay in reaching the final Carnegie stage (β≥10 cigarettes/day = −0.510, 95% CI −0.834; −0.186, P = 0.002). In the second trimester, periconceptional smoking was associated with a smaller femur length (βcigarettes/day = −0.077, 95% CI −0.147; −0.008, P = 0.029) and a larger head circumference (β1–9 cigarettes/day = 0.290, 95% CI 0.065; 0.514, P = 0.012). Smoking was associated with a lower birth weight, with a dose-response effect (βcigarettes/day = −0.150, 95% CI −0.233; −0.068, P < 0.001). Furthermore, using the unadjusted model, 40–60% of the association between smoking and fetal ultrasound parameters and 6.3% of the association between smoking and birth weight can be explained by a delayed embryonic morphology. LIMITATIONS, REASONS FOR CAUTION The study population was recruited from a tertiary referral center. Smoking habits were explored using self-reported questionnaires and checked for consistency by trained researchers. WIDER IMPLICATIONS OF THE FINDINGS This study shows that the association of periconceptional maternal smoking and human morphological development can already be detected early in the first trimester of pregnancy using embryonic morphology as outcome. One of the key messages of this study is that the delay, or dysregulation, in embryonic morphology is associated with allometric growth reflected by smaller fetal measurements at 20 weeks gestation and lower weight at birth. The delay in embryonic morphology, measured in early pregnancy, cannot be recuperated during the pregnancy. The results of this study emphasize the importance of smoking intervention programs prior to conception. More research is warranted to assess the association between periconceptional smoking cessation and embryonic development. STUDY FUNDING/COMPETING INTEREST(S) The work was funded by the Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

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Lofamia, Eliza Angela A., Gliceria B. Ramos, Mark Anthony C. Mamon, Felice Margarette Salido, Glenn Sia Su, and Miriam P. de Vera. "Isoflavone maternal-supplementation during periconception period: Influence on the reproductive organs of the first generation (F1) murine weanling-stage offspring." Asian Pacific Journal of Reproduction 3, no. 4 (December 2014): 268–74. http://dx.doi.org/10.1016/s2305-0500(14)60038-5.

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Sen, U., E. Sirin, S. Yildiz, Y. Aksoy, Z. Ulutas, and M. Kuran. "The effect of maternal nutrition level during the periconception period on fetal muscle development and plasma hormone concentrations in sheep." Animal 10, no. 10 (2016): 1689–96. http://dx.doi.org/10.1017/s1751731116000835.

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Hoek, Jeffrey, Sam Schoenmakers, Esther B. Baart, Maria P. H. Koster, Sten P. Willemsen, Eva S. van Marion, Eric A. P. Steegers, Joop S. E. Laven, and Régine P. M. Steegers-Theunissen. "Preconceptional Maternal Vegetable Intake and Paternal Smoking Are Associated with Pre-implantation Embryo Quality." Reproductive Sciences 27, no. 11 (June 15, 2020): 2018–28. http://dx.doi.org/10.1007/s43032-020-00220-8.

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Abstract Inadequate nutrition and lifestyle behaviors, particularly during the periconception period, are associated with a negative impact on embryonic and subsequent fetal development. We investigated the associations between parental nutritional and lifestyle factors and pre-implantation embryo development. A total of 113 women and 41 partners, with a corresponding 490 embryos, who underwent intracytoplasmic sperm injection (ICSI) treatment subscribed to the mHealth coaching platform “Smarter Pregnancy.” At baseline, nutrition and lifestyle behaviors (intake of fruits, vegetables, folic acid, and smoking and alcohol use) were identified and risk scores were calculated. A lower risk score represents healthier behavior. As outcome measure, a time-lapse morphokinetic selection algorithm (KIDScore) was used to rank pre-implantation embryo quality on a scale from 1 (poor) to 5 (good) after being cultured in the Embryoscope™ time-lapse incubator until embryonic day 3. To study the association between the nutritional and lifestyle risk scores and the KIDScore in men and women, we used a proportional odds model. In women, the dietary risk score (DRS), a combination of the risk score of fruits, vegetables, and folic acid, was negatively associated with the KIDScore (OR 0.86 (95% CI 0.76 to 0.98), p = 0.02). This could mainly be attributed to an inadequate vegetable intake (OR 0.76 (95% CI 0.59 to 0.96), p = 0.02). In men, smoking was negatively associated with the KIDscore (OR 0.53 (95% CI 0.33 to 0.85), p < 0.01). We conclude that inadequate periconceptional maternal vegetable intake and paternal smoking significantly reduce the implantation potential of embryos after ICSI treatment. Identifying modifiable lifestyle risk factors can contribute to directed, personalized, and individual recommendations that can potentially increase the chance of a healthy pregnancy.

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Silva, G. M., C. D. Chalk, J. Ranches, T. M. Schulmeister, D. D. Henry, N. DiLorenzo, J. D. Arthington, P. Moriel, and P. A. Lancaster. "Effect of rumen-protected methionine supplementation to beef cows during the periconception period on performance of cows, calves, and subsequent offspring." Animal 15, no. 1 (January 2021): 100055. http://dx.doi.org/10.1016/j.animal.2020.100055.

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Mitchell, Linda M., John J. Robinson, Robert G. Watt, Thomas G. McEvoy, Cheryl J. Ashworth, John A. Rooke, and Cathy M. Dwyer. "Effects of cobalt/vitamin B12 status in ewes on ovum development and lamb viability at birth." Reproduction, Fertility and Development 19, no. 4 (2007): 553. http://dx.doi.org/10.1071/rd07012.

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Scottish Blackface ewes from cobalt-deficient farmland were fed a diet containing 0.06 mg cobalt per kg dry matter from approximately 30 days before embryo recovery/transfer until lambing. Ewes remained untreated (–Co; n = 82) or were given an intraruminal cobalt-containing bolus to compensate for the dietary deficit (+Co; n = 82). Ewes used as embryo donors (–Co, n = 17; +Co, n = 16) were artificially inseminated with semen from a single Suffolk sire. Day 6 embryos obtained from –Co and +Co donors were transferred in singleton to –Co and +Co recipients in a 2 × 2 factorial-designed experiment to determine the effects of cobalt/vitamin B12 status during the periconception period (factor 1) and pregnancy (factor 2) on lamb viability at birth. Mean (± s.e.m.) circulating concentrations of vitamin B12 in –Co and +Co donors at ovum recovery were 182 ± 10 and 1288 ± 64 pmol L–1, respectively (P < 0.001), and the number of corpora lutea per ewe ovulating was 9.9 ± 1.6 and 14.4 ± 1.3, respectively (P < 0.05). Treatment did not affect the proportion of recovered ova that contained >32 cells (viable) or the median stage of development (late morula), but viable ova recovered from –Co v. +Co ewes had a better morphological grade (2.0 ± 0.1 v. 2.20 ± 0.04, respectively; P < 0.01). There was no effect of treatment on the proportion of recipient ewes that became pregnant. Circulating concentrations of vitamin B12 were lower in –Co than +Co ewes during pregnancy (P < 0.001) and at birth in lambs born to –Co ewes compared with those born to +Co ewes (P < 0.001). There was no effect of donor or recipient cobalt/vitamin B12 status on lamb birthweight, neonatal vigour or neonatal rectal temperatures, but lambs derived from +Co v. –Co embryo donors were more active in the first 3 days after birth (P < 0.05). Results show that sub-clinical cobalt/vitamin B12 deficiency reduces ovulatory response in superovulated ewes and that periconception nutrition can affect neonatal lamb behaviour.

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Budiani, Ni Nyoman, I. Nyoman Mangku Karmaya, IB Putra Manuaba, and Bagus Komang Satriyasa. "The Number of Leydig Cells, Sertoli Cells, and Spermatogonia are Lower towards a Little Rats that Their Parent Given Genistein during Periconception Period." International Research Journal of Engineering, IT & Scientific Research 3, no. 2 (March 1, 2017): 1. http://dx.doi.org/10.21744/irjeis.v3i2.382.

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The testis was composed by the cells of Leydig, Sertoli, and Spermatogenic. The cells formation itself was able to be disrupted by exposure to an endocrine disrupting chemical (EDC) since the prenatal period. The research was intended to prove that Genistein could obstruct the formation of Leydig cells, Sertoli cells, Spermatogenic of rats. The randomized post-test only control group design method was conducted towards white female Wistar rats, 12-13 weeks old, has been had one child, could normally eat and drink. The analysis unit was the child of mother rat treatment group that given Genistein of 10 mg/kg/day and the control group that received distilled water, each of them were 15. The research was done in the Laboratory of Faculty of Veterinary Medical, Udayana University, from January to July 2016. The computer was used for analyzing the data using, with α of 0.05. The result was the Genistein child had an average of 5.464 Sertoli cell, 11.120 Leydig cell, and 48.427 spermatogonia, whereas, the control group had an average of 8.173 Leydig cells, 12.987 Sertoli cells, and 69.547 spermatogonia. There were significant differences between the two groups (p 0.000). The conclusion was that an average of Leydig cells, Sertoli cells, and Spermatogonia lower in children whose their parent rats given Genistein during Periconception period.

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Copping, Katrina J., Andrew Hoare, I. Caroline McMillen, Raymond J. Rodgers, Charles R. Wallace, and Viv E. A. Perry. "Maternal periconceptional and first trimester protein restriction in beef heifers: effects on maternal performance and early fetal growth." Reproduction, Fertility and Development 32, no. 9 (2020): 835. http://dx.doi.org/10.1071/rd19149.

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This study evaluated the effect of protein restriction during the periconception (PERI) and first trimester (POST) periods on maternal performance, physiology and early fetal growth. Yearling nulliparous heifers (n=360) were individually fed a diet high or low in protein (HPeri and LPeri respectively) beginning 60 days before conception. From 24 to 98 days post-conception (dpc), half of each treatment group changed to the alternative post-conception high- or low-protein diet (HPost and LPost respectively), yielding four groups in a 2×2 factorial design with a common diet until parturition. Protein restriction was associated with lower bodyweight subsequent to reduced (but positive) average daily weight gain (ADG) during the PERI and POST periods. During the POST period, ADG was greater in LPeri than HPeri heifers and tended to be greater in LPost than HPost heifers during the second and third trimester. Bodyweight was similar at term. The pregnancy rate did not differ, but embryo loss between 23 and 36 dpc tended to be greater in LPeri than HPeri heifers. Overall, a greater proportion of male fetuses was detected (at 60 dpc 63.3% male vs 36.7% female). Protein restriction altered maternal plasma urea, non-esterified fatty acids, progesterone, leptin and insulin-like growth factor 1 at critical stages of fetal development. However, profiles varied depending on the sex of the conceptus.

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Lai, Ting, Liangcheng Xiang, Zhen Liu, Yi Mu, Xiaohong Li, Nana Li, Shengli Li, et al. "Association of maternal disease and medication use with the risk of congenital heart defects in offspring: a case-control study using logistic regression with a random-effects model." Journal of Perinatal Medicine 47, no. 4 (May 27, 2019): 455–63. http://dx.doi.org/10.1515/jpm-2018-0281.

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AbstractObjectiveTo examine the association between maternal diseases and congenital heart defects (CHDs) and to evaluate whether those associations vary with corresponding medication use.MethodsA multi-hospital case-control study conducted from February 2010 to December 2014 analysed 916 controls and 1236 cases. Participating mothers were asked whether they suffered from influenza, common cold, herpes and threatened abortion or had used corresponding medication during the periconception period or the early pregnancy period. We used a random-effects logistic regression model to compute the odds ratios (ORs), adjusted odds ratios (AORs) and 95% confidence intervals (CIs) while controlling for potential confounders.ResultsCompared with the results for mothers with no exposure, there were significant associations between maternal diseases with medication non-use and CHDs in the aggregate, including influenza (AOR, 1.83; 95% CI, 1.13–2.95), common cold (AOR, 2.05; 95% CI, 1.60–2.64) and herpes (AOR, 7.00; 95% CI, 2.15–22.84). There was no significant association between medication users and offspring with any subtype of CHDs, except that maternal common cold with medication use slightly increased the risk of the specific subtype, namely, isolated cardiac defects. However, an association was observed between maternal threatened abortion and medication and isolated cardiac defects (AOR, 1.33; 95% CI, 1.01–1.75).ConclusionMaternal influenza, common cold, herpes and threatened abortion from 3 months before pregnancy through the first trimester were associated with an increased risk of congenital heart disease in offspring. The teratogenic effect of these conditions may be attenuated by medication use, except for threatened abortion.

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Mahé, Coline, Paulo Marcelo, Guillaume Tsikis, Daniel Tomas, Valérie Labas, and Marie Saint-Dizier. "The bovine uterine fluid proteome is more impacted by the stage of the estrous cycle than the proximity of the ovulating ovary in the periconception period." Theriogenology 198 (March 2023): 332–43. http://dx.doi.org/10.1016/j.theriogenology.2023.01.006.

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Lecorguillé, Marion, Sandrine Lioret, Blandine de Lauzon-Guillain, Erwan de Gavelle, Anne Forhan, François Mariotti, Marie-Aline Charles, and Barbara Heude. "Association between Dietary Intake of One-Carbon Metabolism Nutrients in the Year before Pregnancy and Birth Anthropometry." Nutrients 12, no. 3 (March 20, 2020): 838. http://dx.doi.org/10.3390/nu12030838.

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Few studies have evaluated the role of methylation-pathway nutrients involved in fetal growth (B vitamins, choline, betaine, and methionine). These one-carbon metabolism (OCM) nutrients are essential for DNA methylation in the periconception period. We aimed to characterize dietary patterns of 1638 women from the EDEN mother-child cohort in the year before pregnancy according to the contribution of OCM nutrients and to study the association of such patterns with anthropometric measurements at birth. Dietary intake before pregnancy was assessed by using a semi-quantitative food frequency questionnaire. We used the reduced-rank regression (RRR) method to identify dietary patterns using OCM nutrients as intermediate variables. We ran linear regressions models to study the association between dietary patterns scores and birth weight, length, head circumference, gestational age, and sex-specific z-scores, adjusting for maternal characteristics and vitamin supplementation before and during pregnancy. Three patterns, “varied and balanced”, “vegetarian tendency”, and “bread and starchy food” were identified, explaining 58% of the variability in OCM nutrient intake. Higher scores on the “varied and balanced” pattern tended to be associated with higher birth length and weight. In mainly well-nourished young French women, we did not find evidence that variability in OCM nutrient intake has major effects on fetal growth.

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Xu, Juan, and Kevin D. Sinclair. "One-carbon metabolism and epigenetic regulation of embryo development." Reproduction, Fertility and Development 27, no. 4 (2015): 667. http://dx.doi.org/10.1071/rd14377.

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One-carbon (1C) metabolism consists of an integrated series of metabolic pathways that include the folate cycle and methionine remethylation and trans-sulfuration pathways. Most, but not all, 1C metabolic enzymes are expressed in somatic cells of the ovary, mammalian oocytes and in preimplantation embryos. The metabolic implications of this, with regard to the provision of methyl donors (e.g. betaine) and 1C cofactors (e.g. vitamin B12), together with consequences of polymorphic variances in genes encoding 1C enzymes, are not fully understood but are the subject of ongoing investigations at the authors’ laboratory. However, deficiencies in 1C-related substrates and/or cofactors during the periconception period are known to lead to epigenetic alterations in DNA and histone methylation in genes that regulate key developmental processes in the embryo. Such epigenetic modifications have been demonstrated to negatively impact on the subsequent health and metabolism of offspring. For this reason, parental nutrition around the time of conception has become a focal point of investigation in many laboratories with the aim of providing improved nutritional advice to couples. These issues are considered in detail in this article, which offers a contemporary overview of the effects of 1C metabolism on epigenetic programming in mammalian gametes and the early embryo.

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Rottenstreich, A., S. Fridman Lev, R. Rotem, T. Mishael, B. Koslowsky, E. Goldin, S. Grisaru-Granovsky, and A. Bar-Gil Shitrit. "P242 Prior pregnancy outcome is an important determinant of subsequent pregnancy outcome in women with inflammatory bowel diseases." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S266—S267. http://dx.doi.org/10.1093/ecco-jcc/jjz203.371.

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Abstract Background Inflammatory bowel diseases (IBD) are commonly diagnosed in women of childbearing age. As such, pregnancy is often encountered in this subset of patients. Disease flare throughout gestation are not uncommon and can substantially affect pregnancy outcomes. We aimed at the effect of prior pregnancy outcome on the risk of disease flare at subsequent pregnancy in women with IBD. Methods Women with IBD attending a multidisciplinary clinic for the preconception, antenatal and postnatal treatment were prospectively recruited during 2011–2018. Results Overall, 476 IBD women were followed during the study period. Of them, 69 (14.5%) had two pregnancies throughout the follow-up period and constituted the study cohort. Among these 69 women, 48 (69.6%) had Crohn’s disease and 21 (30.4%) ulcerative colitis. The median interpregnancy interval was 20 [11–32] months. Overall, 34 (49.3%) women experienced disease flare at the subsequent pregnancy. In multivariate analysis, active disease at conception (odds ratio [95% CI]: 25.65 (3.05, 215.52), p < 0.001) and history of disease flare at the previous pregnancy (odds ratio [95% CI]: 4.21 (1.10, 16.58), p < 0.001) were the only independent predictors of disease relapse in current gestation. Rates of hospitalisation during pregnancy (14.7% vs. 0, p = 0.02) and preterm delivery (32.4% vs. 5.7%, p = 0.006) were higher, and neonatal birth weight was lower (median 3039 vs. 3300 grams, p = 0.03), in those with disease flare as compared with those with maintained remission. Conclusion History of disease relapse at previous gestation and periconception disease activity were found as an important predictor of disease flare among IBD women. These data would facilitate adequate counselling and informed management decisions among reproductive-aged IBD women and their treating physicians.

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Mazzucco, Walter, Elisa Tavormina, Maurizio Macaluso, Claudia Marotta, Rosanna Cusimano, Davide Alba, Claudio Costantino, et al. "Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily." BMJ Open 9, no. 7 (July 2019): e027912. http://dx.doi.org/10.1136/bmjopen-2018-027912.

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ObjectivesIn response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.SettingA community living near the largest landfill plant in Sicily.ParticipantsThe study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire’s peak might have influenced pregnancy.Primary and secondary outcome measuresBirth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.ResultsAmong singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.ConclusionsThe study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

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Belenchia, Anthony M., Sarah A. Johnson, Mark R. Ellersieck, Cheryl S. Rosenfeld, and Catherine A. Peterson. "In utero vitamin D deficiency predisposes offspring to long-term adverse adipose tissue effects." Journal of Endocrinology 234, no. 3 (September 2017): 301–13. http://dx.doi.org/10.1530/joe-17-0015.

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The fetal period represents an important window of susceptibility for later obesity and metabolic disease. Maternal vitamin D deficiency (VDD) during pregnancy is a global concern that may have long-lasting consequences on offspring metabolic health. We sought to determine whether a VDD in utero environment affects fetal adipose tissue development and offspring metabolic disease predisposition in adulthood. Furthermore, we sought to explore the extent to which the VDD intrauterine environment interacts with genetic background or postnatal environment to influence metabolic health. Eight-week-old P0 female C57BL/6J mice were fed either a VDD diet or sufficient diet (VDS) from four weeks before pregnancy (periconception) then bred to male Avy/a mice. Females were maintained on the diets throughout gestation. At weaning, Avy/a and a/a male F1 offspring were randomized to low-fat (LFD) or high-fat diet (HFD) until 19 weeks of age, at which point serum and adipose tissue were harvested for analyses. Mice born to VDD dams weighed less at weaning than offspring born to VDS dams but experienced rapid weight gain in the four weeks post weaning, and acquired a greater ratio of perigonadal (PGAT) to subcutaneous (SQAT) than control offspring. Additionally, these mice were more susceptible to HFD-induced adipocyte hypertrophy. Offspring of VDD dams also had greater expression of Pparg transcript. These novel findings demonstrate that in utero VDD, an easily correctable but highly prevalent health concern, predisposes offspring to long-term adipose tissue consequences and possible adverse metabolic health complications.

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Wakefield, Sarah L., Michelle Lane, Samantha J. Schulz, Michelle L. Hebart, Jeremy G. Thompson, and Megan Mitchell. "Maternal supply of omega-3 polyunsaturated fatty acids alter mechanisms involved in oocyte and early embryo development in the mouse." American Journal of Physiology-Endocrinology and Metabolism 294, no. 2 (February 2008): E425—E434. http://dx.doi.org/10.1152/ajpendo.00409.2007.

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Despite the well-known benefits of omega-3 ( n-3) polyunsaturated fatty acid (PUFA) supplementation on human health, relatively little is known about the effect of n-3 PUFA intake on fertility. More specifically, the aim of this study was to determine how oocyte and preimplantation embryo development might be influenced by n-3 PUFA supply and to understand the possible mechanisms underlying these effects. Adult female mice were fed a control diet or a diet relatively high in the long-chain n-3 PUFAs for 4 wk, and ovulated oocytes or zygotes were collected after gonadotropin stimulation. Oocytes were examined for mitochondrial parameters (active mitochondrial distribution, mitochondrial calcium and membrane potential) and oxidative stress, and embryo developmental ability was assessed at the blastocyst stage following 1) in vitro fertilization (IVF) or 2) culture of in vivo-derived zygotes. This study demonstrated that exposure of the oocyte during maturation in the ovary to an environment high in n-3 PUFA resulted in altered mitochondrial distribution and calcium levels and increased production of reactive oxygen species. Despite normal fertilization and development in vitro following IVF, the exposure of oocytes to an environment high in n-3 PUFA during in vivo fertilization adversely affected the morphological appearance of the embryo and decreased developmental ability to the blastocyst stage. This study suggests that high maternal dietary n-3 PUFA exposure periconception reduces normal embryo development in the mouse and is associated with perturbed mitochondrial metabolism, raising questions regarding supplementation with n-3 PUFAs during this period of time.

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van Dijk, Matthijs R., Maria P. H. Koster, Elsje C. Oostingh, Sten P. Willemsen, Eric A. P. Steegers, and Régine P. M. Steegers-Theunissen. "A Mobile App Lifestyle Intervention to Improve Healthy Nutrition in Women Before and During Early Pregnancy: Single-Center Randomized Controlled Trial." Journal of Medical Internet Research 22, no. 5 (May 15, 2020): e15773. http://dx.doi.org/10.2196/15773.

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Background Unhealthy nutrition contributes to the worldwide rising prevalence of noncommunicable diseases. As most adverse reproductive outcomes originate during the periconception period, effective interventions targeting this period are needed. Therefore, we developed the lifestyle intervention Smarter Pregnancy to empower women to adapt a healthy diet prior to conception and during early pregnancy and performed a randomized controlled trial. Objective The objectives of this trial were to investigate compliance and effectiveness in women using the Smarter Pregnancy program. Methods Women aged between 18 and 45 years who were contemplating pregnancy or <13 weeks pregnant and their male partners living in the urban area of Rotterdam, the Netherlands, were eligible for participation. After baseline screening, the intervention group received personal online coaching based on identified inadequate intakes of vegetables, fruits, and folic acid supplements. The sum of these risk factors was used as a dietary risk score (DRS), ranging from 0 (healthy) to 9 (unhealthy). The control group did not receive coaching. We applied an intention-to-treat principle and used a multivariable linear regression model to evaluate the change in DRS after 24 weeks. Compliance was defined as the percentage of women who completed the screening questionnaire at 24 weeks. Results Of women recruited, 81.2% (177/218) completed the program (intervention: 91/218, 83.5%; control: 86/218, 78.9%; P=.95). After 24 weeks, the reduction in DRS of women in the intervention group was significantly larger than in the control group (β=.75, 95% CI 0.18-1.34). This reduction was mainly due to increased vegetable intake (β=.55, 95% CI 0.25-0.86). Conclusions The high compliance and the larger improvements in nutritional behaviors, especially vegetable intake, in women in the intervention group emphasizes the effectiveness of empowering women by using the lifestyle change intervention Smarter Pregnancy. Trial Registration Netherlands Trial Register: NL3927; https://www.trialregister.nl/trial/3927 International Registered Report Identifier (IRRID) RR2-10.1186/s12884-017-1228-5

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Brat, R., A. Rolland, R. Thieme, M. Dahirel, G. Boyer, A. Navarette-Santos, B. Fischer, P. Boileau, and P. Chavatte-Palmer. "98 THE FETAL AND POSTNATAL EFFECTS OF PERICONCEPTIONAL HYPERGLYCEMIA USING A RABBIT MODEL." Reproduction, Fertility and Development 23, no. 1 (2011): 154. http://dx.doi.org/10.1071/rdv23n1ab98.

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The objective of this study was to analyse the effects of maternal hyperglycemia during the periconception period on fetal and postnatal development using a rabbit model. Diabetes was induced in adult New Zealand female does by a single intravenous alloxan injection (group D). Glycemia was maintained between 3 and 5 g L–1 with 2 daily subcutaneous insulin injections. Does from group D and contemporary controls (group C) were naturally mated 1 wk after induction of diabetes in group D animals, without superovulation, and embryos collected after sacrifice on Day 4 post-coitum. In Expt. 1, embryos from D (n = 11) and C (n = 13) groups were transferred respectively to the right and left horns of 3 female recipients, which were killed on Day 28. In Expt. 2, 17 D and 16 C females were mated naturally. 68 D and 98 C embryos were collected and transferred to 26 non-diabetic recipients (6–7 embryos per doe). 17 females were pregnant with no difference between C and D recipients. Fetal development was monitored by ultrasound. At birth, litters were equilibrated in number. 15 D and 7 C pups (from 4 D and 2 C litters) were killed at weaning (1 month of age). The remaining 13 D and 26 C pups (4 D and 7 C litters) were allocated to 1 of 2 feeding groups: control or obesogenic diet. The obesogenic diet was based on the control diet supplemented with animal fat (suet, 200%) and glucose (200%). Bodyweight, adiposity, and glucose metabolism were monitored until sacrifice at 5 months of age. Data were analysed by ANOVA using litter (fetuses), litter and sex (weaning), and litter and diet (5 months) as co-factors. Sex effects at 5 months were not analysed due to small numbers of animals. Fetal development was not different between D and C groups. Fetal, placental, and fetal organ weights did not differ at Day 28, except for brain weight, which was significantly lower in D fetuses (0.86 ± 0.1 v. 1.05 ± 0.08 g; P < 0.05). There was no difference in litter size at birth (3.3 ± 0.3 v. 3.6 ± 0.5 pups for D and C groups, respectively; P = 0.5), but birthweight was significantly increased in D offspring (211 ± 6 v. 194 ± 6 g; P < 0.05). There was no difference in weight after 14 days. At 1 month of age, adiposity, plasma insulin and leptin concentrations were not different between groups. In contrast, in male D offspring, fasting glycemia was significantly lower (1.7 ± 0.2 v. 2.1 ± 0.02 g L–1; P < 0.01), plasma insulin-like growth factor 1 was significantly increased (P < 0.05) and kidney/bodyweight ratio was significantly reduced (0.41 ± 0.03 v. 0.45 ± 0.04; P < 0.01). From 12 wk of age, bodyweight became significantly different between D and C groups and according to diet (P < 0.005), with D individuals being lighter than C individuals for each dietary group. Finally, fasting glycemia was significantly higher in the animals fed the obesogenic diet (1.35 ± 0.05 v. 1.19 ± 0.05 g L–1; P < 0.04), regardless of group. These data suggest that maternal hyperglycemia during the periconceptional period affects glucose metabolism and organ development in offspring with sexual dimorphism.

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Bijl, Rianne C., Jérôme M. J. Cornette, Annemien E. van den Bosch, Johannes J. Duvekot, Jeroen Molinger, Sten P. Willemsen, Anton H. J. Koning, et al. "Study protocol for a prospective cohort study to investigate Hemodynamic Adaptation to Pregnancy and Placenta-related Outcome: the HAPPO study." BMJ Open 9, no. 11 (November 2019): e033083. http://dx.doi.org/10.1136/bmjopen-2019-033083.

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IntroductionThe importance of cardiovascular health in relation to pregnancy outcome is increasingly acknowledged. Women who develop certain pregnancy complications, in particular preeclampsia, are at higher risk for future cardiovascular disease. Independent of its outcome, pregnancy requires a substantial adaptive response of the maternal cardiovascular system. In the Hemodynamic Adaptation to Pregnancy and Placenta-related Outcome (HAPPO) study, we aim to examine longitudinal maternal haemodynamic adaptation to pregnancy from the preconception period onwards. We hypothesise that women who will develop adverse pregnancy outcomes have impaired cardiovascular health before conception, leading to haemodynamic maladaptation to pregnancy and diminished uteroplacental vascular development.Methods and analysisIn this prospective cohort study embedded in the Rotterdam periconception cohort, 200 women with a history of placenta-related pregnancy complications (high-risk group) and 100 women with an uncomplicated obstetric history (low-risk group) will be included. At five moments (preconception, first, second and third trimester and postdelivery), women will undergo an extensive examination of the macrocirculatory and microcirculatory system and uteroplacental vascular development. The main outcome measures are differences in maternal haemodynamic adaptation to pregnancy between women with and without placenta-related pregnancy complications. In a multivariate linear mixed model, the relationship between maternal haemodynamic adaptive parameters, (utero)placental vascularisation indices and clinical outcomes (occurrence of pregnancy complications, embryonic and fetal growth trajectories, miscarriage rate, gestational age at delivery, birth weight) will be studied. Subgroup analysis will be performed to study baseline and trajectory differences between high-risk and low-risk women, independent of subsequent pregnancy outcome.Ethics and disseminationThis study protocol was approved by the Medical Ethics Committee of the Erasmus MC, Rotterdam, the Netherlands (MEC 2018–150). Results will be disseminated to the medical community by publications in peer-reviewed journals and presentations at scientific congresses. Also, patient associations will be informed and the public will be informed by dissemination through (social) media.Trial registration numberNL7394 (www.trialregister.nl)

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Autret-Leca, Elisabeth, Jean Deligne, Joffray Leve, Agnès Caille, Hawaré Cissoko, and Annie Pierre Jonville-Bera. "Drug Exposure during the Periconceptional Period." Pediatric Drugs 13, no. 5 (October 2011): 317–24. http://dx.doi.org/10.2165/11591260-000000000-00000.

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Timmermans, Yvon E. G., Kim D. G. van de Kant, Dorien Reijnders, Lina M. P. Kleijkers, Edward Dompeling, Boris W. Kramer, Luc J. I. Zimmermann, Régine P. M. Steegers-Theunissen, Marc E. A. Spaanderman, and Anita C. E. Vreugdenhil. "Towards Prepared mums (TOP-mums) for a healthy start, a lifestyle intervention for women with overweight and a child wish: study protocol for a randomised controlled trial in the Netherlands." BMJ Open 9, no. 11 (November 2019): e030236. http://dx.doi.org/10.1136/bmjopen-2019-030236.

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IntroductionPericonception obesity is associated with a higher risk for adverse perinatal outcomes such as gestational diabetes mellitus, preeclampsia, large for gestational age, operative delivery and preterm birth. Lifestyle interventions during pregnancy have resulted in insufficient effects on reducing these perinatal complications. A few reasons for this disappointing effect can be suggested: (1) the time period during pregnancy for improvement of developmental circumstances is too short; (2) the periconception period in which complications originate is not included; and (3) lifestyle interventions may not have been sufficiently multidisciplinary and customised. A preconception lifestyle intervention might be more effective to reduce perinatal complications. Therefore, the aim of the Towards Prepared mums study is to evaluate the effect of a lifestyle intervention starting prior to conception on lifestyle behaviour change.Methods and analysisThis protocol outlines a non-blinded, randomised controlled trial. One hundred and twelve women (18–40 years of age) with overweight or obesity (body mass index≥25.0 kg/m2) who plan to conceive within 1 year will be randomised to either the intervention or care as usual group. The intervention group will receive a multidisciplinary, customised lifestyle intervention stimulating physical activity, a healthy diet and smoking cessation, if applicable. The lifestyle intervention and monitoring will take place until 12 months postpartum. The primary outcome is difference in weight in kg from baseline to 6 weeks postpartum. Secondary outcomes are gestational weight gain, postpartum weight retention, smoking cessation, dietary and physical activity habits. Furthermore, exploratory outcomes include body composition, cardiometabolic alterations, time to pregnancy, need for assisted reproductive technologies, perinatal complications of mother and child, and lung function of the child. Vaginal and oral swabs, samples of faeces, breast milk, placenta and cord blood will be stored for evaluation of microbial flora, epigenetic markers and breast milk composition. Furthermore, a cost-effectiveness analysis will take place.Ethics and disseminationEthical approval was obtained from the Medical Ethical Committee of Maastricht University Medical Centre+ (NL52452.068.15/METC152026). Knowledge derived from this study will be made available by publications in international peer-reviewed scientific journals and will be presented at (inter)national scientific conferences. A dissemination plan for regional and national implementation of the intervention is developed.Trial registration numberClinicalTrials.gov NCT02703753.

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Cetin, I., C. Berti, and S. Calabrese. "Role of micronutrients in the periconceptional period." Human Reproduction Update 16, no. 1 (June 30, 2009): 80–95. http://dx.doi.org/10.1093/humupd/dmp025.

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Shamsuddin, Hala, Casey Raudenbush, Brittany Sciba, Erica N. Gooch, Wayne Greaves, Ronald W. Leong, and Walter Straus. "886. Pregnancy Outcomes Following Raltegravir Exposure." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S20—S21. http://dx.doi.org/10.1093/ofid/ofz359.045.

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Abstract Background Safety data are needed regarding HIV treatment in women of reproductive potential and during pregnancy. This review is to evaluate pregnancy outcomes following prospective exposures (exposure report prior to knowledge of pregnancy outcome) to raltegravir during pregnancy. Methods Exposures to raltegravir during pregnancy reported cumulatively through March 26, 2019 to the internal safety database at Merck & Co., Inc. were reviewed. This database includes all reports of pregnancy from clinical trials sponsored by the company, spontaneous post-marketing reports, and noninterventional data sources. Prospective pregnancy reports were evaluated to determine rates of spontaneous abortion, stillbirth, and congenital anomalies, including neural tube defects. Data from two ongoing cohorts of pregnant women with HIV-1 infection, not included in the internal safety database, were also reviewed. Results A total of 2,508 prospective pregnancy reports with reported outcomes were identified among women exposed to raltegravir: 919 from the internal safety database (Table 1) and 1,589 from the UK/Ireland and French pregnancy cohorts. Among the 2,508 prospective pregnancy exposures, 945 were in the first trimester, of which 757 were within the periconception period (within 28 days of conception). Of the 471 documented first trimester exposures identified in the internal safety database, the rates of spontaneous abortion (6.9%), stillbirth (1%), and congenital anomalies (1.5% per live births) were similar to the rates observed in the background populations of the United States Among outcomes following any exposure, the rate of congenital anomalies was 3.4% per live births. There were no reports of neural tube defects identified within the internal safety database or among the cohort data. Conclusion Prospectively collected pregnancy outcome data do not suggest an association between raltegravir exposure and spontaneous abortion, stillbirth, or congenital anomalies, including neural tube defects. These data support the current HIV treatment recommendations for the use of raltegravir 400 mg twice daily in women of reproductive potential and during pregnancy. Disclosures All Authors: No reported Disclosures.

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Journal articles on the topic 'Periconception period'

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