Generation R Next - Optimaal Opgroeien

Preconception and early pregnancy are critical periods for health and wellbeing across the full life course in the offspring. Improving lifestyle, nutrition and stress in both women and their partners already from the preconception period onwards may have beneficial effects on the offspring.

This RCT will include preconception/early pregnancy integrated life style intervention focused on a healthy weight (BMI: 18.5-25 kg/m2), stopping alcohol/smoking/drugs, supplementing folic acid and vitamin D, a healthy diet (weekly fish, iron and vitamin C rich food) and stress reduction. Reducing stress appears to be effective for improving (maternal) health and reducing risk behavior. Mind-body therapy, a combination of yoga exercises and mindfulness seems to be a popular intervention, especially among pregnant women or women of childbearing age from various ethnic backgrounds.

The use of the preconception consultation is not yet optimal. This is partly due to the difficulty of reaching (vulnerable) groups and the limited insight regarding the efficacy.

The aim of this randomized controlled trial is to improve birth outcomes and long-term outcomes in mother and child by optimizing lifestyle in the preconception period and early pregnancy in women and men. The main research question is whether an intervention focused on optimizing preconception and early pregnancy lifestyle, nutrition and stress improves the birth outcomes and long-term outcomes in mother and child?

This RCT will be embedded in the available Generation R Next research infrastructure.

Prior to randomization, the intervention and control groups will be offered an individual lifestyle consultation for both women and men, and, if pregnant, an early pregnancy ultrasound. After randomization, there will be two groups: the intervention group and the control group. Both groups will receive standard care, including an individual lifestyle consultation in line with current national standards for preconception and early pregnancy. The intervention group will additionally attend three group sessions (online and physical) focused on health during preconception and early pregnancy, coping with stress and adherence to a healthy lifestyle. The advices are based on national guidelines for health during the preconception period and early pregnancy. Compliance with the prescribed advice is encouraged via newly developed digital platform

• Adherence to lifestyle advice (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Sleep/wake rhythm (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Sleep/wake rhythm (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Social support (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Experience of stress (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Weight gain during pregnancy (mother) [Time frame: During pregnancy and early childhood, until 12 months]
• Weight maintenance after 6 and 12 months pregnancy (mother) [Time frame: 12 months after birth of the child]
• Time to pregnancy (mother) [Time frame: At delivery]
• Occurrence of miscarriage (mother) [Time frame: At delivery]
• Glucose metabolism and diabetes during pregnancy (mother) [Time frame: At delivery]
• Occurrence of gestational hypertensive disorders during pregnancy (mother) [Time frame: At delivery]
• Adherence to lifestyle advice (partner) [Time frame: During pregnancy and early childhood, until 12 months]