Maternal lifestyle risk factors and human embryonic morphologic development using 3D ultrasound: a population-based prospective cohort study

Naomi Graafland; Anke G. Posthumus; A. Mulders; Romy Gaillard; Anton H J Koning; Vincent W. V. Jaddoe; Steegers Ea; Melek Rousian

doi:10.1093/humrep/deag125

July 18, 2026Human ReproductionOpen Access

Maternal lifestyle risk factors and human embryonic morphologic development using 3D ultrasound: a population-based prospective cohort study

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Key Points

To determine whether maternal periconceptional lifestyle factors—including smoking, alcohol, caffeine, physical activity, and folic acid use—are associated with embryonic morphologic development and growth.
Prospective cohort study analyzing 993 singleton pregnancies from the Generation R Next Study in Rotterdam, the Netherlands (2017–2021) with validated dating and 3D ultrasound data up to 10 + 2 weeks of gestation.
Embryonic morphologic development was evaluated using virtual reality and Carnegie staging at 7 and 9 weeks, while crown-rump length (CRL) measured growth.
Associations between questionnaire-reported lifestyle factors, serum folate, and embryonic metrics were evaluated using linear mixed models adjusted for maternal sociodemographic and fetal characteristics.
Inadequate folic acid supplementation was associated with a 0.51-day developmental delay and a 0.72-mm reduction in CRL (-1.6%) at 10 + 2 weeks of gestation.
Insufficient maternal serum folate (<25.5 nmol/l) was associated with a 1.01-day developmental delay and a 1.24-mm reduction in CRL (-3.7%).
No statistically significant associations were identified between early embryonic development or CRL and maternal smoking, alcohol consumption, caffeine intake, or physical activity.

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Implication

Prospective cohort study reveals delayed embryonic development and growth with inadequate folic acid, highlighting the importance of periconceptional supplementation.

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Cite This Study

Graafland et al. (2026) studied this question.

synapsesocial.com/papers/6a8312d9162ea9d73e990262 https://doi.org/10.1093/humrep/deag125

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Maternal lifestyle risk factors and human embryonic morphologic development using 3D ultrasound: a population-based prospective cohort study

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Maternal lifestyle risk factors and human embryonic morphologic development using 3D ultrasound: a population-based prospective cohort study

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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