Begin at the beginning: some reflections on future periconceptional and obstetric care and research in the Netherlands

Abstract

Genetic and environmental factors of both parents can cause abnormal development of the embryo and the placenta in early pregnancy, resulting in congenital abnormalities, abnormal intrauterine development, and chronic disease in later life of both the child and the mother. More scientific research into the etiology of abnormal embryogenesis and early placentation are therefore necessary to achieve definitive improvements in pregnancy outcome in the future. Primary prevention in the form of removal of certain risk factors related to developmental disorders in early pregnancy is already possible in many cases. Preconception care should therefore be added to the traditional organization of care surrounding pregnancy. Periconceptional and prenatal medicine can be regarded as the most promising preventive medicine of the future.