Abstract
Poor maternal lifestyles can detrimentally influence placentation in the periconception period, but the extent is largely unknown. We aim to summarise evidence on associations between periconceptional maternal lifestyles and (non-)invasive placental biomarkers throughout pregnancy. A comprehensive search in online (medical) libraries was conducted. Keywords searched related to lifestyles, ie. smoking, alcohol, caffeine, nutrition and body weight. Placental markers searched comprised ultrasound, blood and histological characteristics. Randomised controlled trials and observational studies published between 2000-2017 were included. Methodological quality was scored using the ErasmusAGE tool. From 2,731 retrieved articles, 83 studies were included. Median quality score was 5 (range 0-10). Smoking was associated with lower first-trimester vascularisation flow indices and higher second- and third-trimester resistance in uterine and umbilical arteries on ultrasound. Alcohol use was associated with lower placental weight. Further, one study described higher levels of Placental Growth Factor (PlGF) in the second and third trimester after periconceptional alcohol use. First-trimester nutritional factors, such as periconceptional folic acid supplement intake and adherence to a Mediterranean diet were associated with ultrasound markers, ie. lower resistance in uterine and umbilical arteries. Higher body weight was associated with larger placentas measured by ultrasound or at birth, but also resulted in lower PlGF-levels. Evidence on the impact of periconceptional maternal lifestyles on (non-)invasive placental biomarkers such as ultrasound is heterogeneous. Therefore, research should focus more on the (patho)physiology of lifestyle exposures in the periconception window. This will contribute to the development of better screening tools and interventions to reduce placenta-related pregnancy complications in the future. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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