Even before conception, parents pass on their genes and the associated risks for and chances of a healthy life or illness in later life.

The ROAHD programme is aimed at understanding the effects of paternal and maternal determinants on the developmental process, from gamete to adult, to increase the chances of a healthy life and prevent the occurrence of illness in later life.

The ROAHD research activities include:

  • Investigating paternal and maternal preconceptional, preimplantation, and pregnancy-related determinants and predictors of future health and disease of the mother, the gametes, and the offspring;
  • Investigating screening and diagnostic procedures used before conception and during pregnancy to identify disease, or disease risk, in the mother, the gametes, and the offspring;
  • Exploring interventions used before conception and during pregnancy to promote the health of the mother and the future child;
  • Conducting implementation research to gather evidence for optimal perinatal care.
Relevance

Gaining insight into mechanisms and prevention

Healthy ageing starts before conception and is further determined during embryonic and foetal life. The growth and development of the future adult is affected by the genetic and epigenetic programming of gametes and preimplantation embryos.

According to the Barker hypothesis, the period of pregnancy and the intrauterine environment are crucial to the tendency to develop diseases during adulthood, such as cardiovascular disease, diabetes, lung disease, and possibly psychological vulnerability.

The impact of lifestyle and environmental factors

An unfavourable intrauterine environment can be caused by lifestyle factors such as drug exposure, alcohol consumption, smoking, unhealthy diet, overweight, and chronic psychological stress. These may lead to permanent changes in the structure, function, physiology, and metabolism of the placenta and the foetus.

Potentially unfavourable environments have a negative impact on foetal organ development and gene expression, resulting in a higher susceptibility to the development of chronic disease in later life.

Impact on the mother

Not only a future child may have an increased risk of health problems, but also a mother who has pre-existing diseases or who develops pregnancy-related diseases, such as pre-eclampsia, is at increased risk of future health problems, such as hypertension, diabetes, cardiovascular disease, and renal disease.

Mechanisms of change in placental function and maternal physiology

The exploration of mechanisms and factors that are responsible for changes in placental function and maternal physiology can provide insight into the changes that occur in the mother, the foetus, and the future adult.

Cohort studies, follow-up studies on interventions prior to or during pregnancy as well as animal experimental models within the ROAHD research programme will help to unravel both associations and pathophysiological mechanisms.

  • Preconception and preimplantation research focuses on gametes prior to the stages of conception and implantation when they are susceptible to paternal and environmental influences. This may affect the development of the embryo and the health of the future individual. The overall aim is to optimize pregnancy outcomes.

  • The specific domain of pregnancy focuses on issues associated with the postimplantation dynamic epigenetic, immunological, and metabolic processes in the intimate and reciprocal interactions between the mother, the placenta, and the foetus, which determine foetal development and the course of pregnancy. The research focuses on determinants and epigenetic consequences of pregnancy-associated diseases, such as hypertensive disorders (pre-eclampsia), gestational diabetes, and placental disorders and on the development of techniques for early diagnosis and intervention in both animal and human models.

  • Perinatal morbidity and mortality rates in the northern Netherlands are higher than the national average and urgently require improvement. The organization of healthcare for pregnant couples needs scientific evaluation and evidence-based strategies to improve perinatal outcome for both mother and child. To achieve this, the ROAHD research focuses on the investigation of screening and diagnostic procedures used before conception and during pregnancy, to identify disease, or disease risk, in the mother, the gametes, and the offspring and on the implementation to gather evidence for optimal perinatal care.