Associations Between Periconceptional Lifestyle Behaviour Change and Adverse Pregnancy Outcomes

Abstract Background While the effect of prenatal exposure to unhealthy lifestyle is widely evidenced, little is known about these exposures in the periconception period. We investigated associations between periconceptional lifestyle behaviour change and adverse pregnancy outcomes. Methods A retrospective secondary analysis took place within a prospective multicentre cohort study in the Netherlands, including 3,684 pregnant women. Baseline characteristics and preconceptional and first-trimester lifestyle behaviours were assessed through a self-administered questionnaire. Adverse pregnancy outcomes (hypertensive disorders in pregnancy (HDP), small for gestational age (SGA), gestational diabetes (GDM) and spontaneous preterm birth (sPTB)) were reported by healthcare professionals. Data were collected between December 2012 - January 2014 and analysed between August - December 2019, using multivariate logistic regression. Results Overweight, and especially obese women, have the highest odds of developing any adverse pregnancy outcome (adjusted odds ratio (aOR) 1.61 (95%CI 1.31–1.99) and aOR 2.85 (95%CI 2.20–3.68), respectively), particularly HDP and GDM. Women who prenatally quit smoking had a lower odds of SGA (aOR 1.14 (95%CI 0.59–2.21)), while women who continued smoking attained higher odds (aOR 1.91 (95%CI 1.05–1.15)). Women who did not use folic acid tended to have a higher odds of developing adverse pregnancy outcomes (aOR 1.28 (95%CI 0.97–1.69)), while women who prenatally started folic acid did not (aOR 1.01 (95%CI 0.82–1.25)). Conclusions Our results indicate that smoking cessation, having a lower BMI and initiating folic acid supplements preconceptionally may decrease the risk of adverse pregnancy outcomes. Therefore, intervening as early as the preconception period could benefit the health of future generations.