Even before conception, parents pass on their genes and with them the risks and opportunities for a healthy life course, or the occurrence of illness later in life.

We strive to understand the effects of paternal and maternal determinants on the developmental process from gamete to adult to increase opportunities for a healthy life course, and prevent the occurrence of illness later in life.

In our programme we:

  1. Investigate paternal and maternal preconceptional, preimplantation and pregnancy-related determinants and predictors of future health and disease of the mother, gametes and offspring;
  2. Investigate screening and diagnostic procedures before conception and during pregnancy to identify disease, or disease risk, in the mother, gametes and offspring;
  3. Explore interventions before conception and during pregnancy to promote the health for the future child and mother;
  4. Conduct implementation research for evidence on optimal perinatal care in practice.
Relevance

Insights into mechanisms and prevention

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

The “Barker Hypothesis” suggests that several diseases in adulthood such as cardiovascular disease, diabetes, lung disease and possibly psychiatric vulnerability have their origin during pregnancy.

Lifestyle and environmental factors impact

An unfavorable intra-uterine environment can be caused by lifestyle factors such as drug exposure, alcohol consumption, smoking, unhealthy diet, overweight and chronic psychological stress and may lead to changes that can have a permanent impact on the structure, function, physiology and metabolism of the placenta and the fetus.

Potentially unfavorable environments affect fetal organ development and gene expression and result in an adult with a greater susceptibility to the development of chronic disease later in life.

Impact on mother

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

Mechanisms of change in placental function and maternal physiology

Investigating mechanisms and factors that are responsible for changes in placental function and maternal physiology can help us to understand the changes that occur in the fetus and the future adult, and the mother.

Cohort studies, follow up studies of interventions prior to pregnancy or during pregnancy, as well as animal experimental models within our ROAHD programme will help to elucidate both associations and pathophysiological mechanisms.

  • Preconception/preimplantation research concerns gametes prior to conception and implantation when they are susceptible to influences of parental origin and the environment. This can have consequences for the development of the embryo and the health of the future individual. The overall aim is to always optimize pregnancy outcomes.

  • The specific domain of pregnancy concerns issues resulting from the fact that after implantation, the dynamic epigenetic, immunologic and metabolic processes in the intimate and reciprocal interaction between mother, placenta and fetus determine fetal development and course of pregnancy. Investigating determinants and epigenetic consequences of pregnancy-associated diseases such as hypertensive disorders (pre-eclampsia), diabetes in pregnancy and placental disorders, including development of techniques for early diagnosis and intervention in both animal and human models.

  • Perinatal morbidity and mortality in the northern provinces of the Netherlands are above 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. This will be done by investigation screening and diagnostic procedures before conception and during pregnancy to identify disease, or disease risk, in the mother, gametes and offspring and by conducting implementation research for optimal perinatal care in practice.