Cohort Profile Update: the Rotterdam Periconceptional Cohort—biomarkers, lifestyle intervention, and artificial intelligence

The original cohortExtensive research of the Developmental Origins of Health and Disease (DOHaD) has demonstrated associations between earlylife conditions, perinatal outcomes, and long-term health and disease [1].In the last decades, we have shifted the exposure window to the periconceptional period (14 weeks before to up and until 10 weeks after conception) covering key processes of gametogenesis, embryogenesis, and placentation [2].Since then, parental health and lifestyle during this window have been associated increasingly with pregnancy complications and long-term cardiometabolic and developmental outcomes in offspring [2].The Rotterdam Periconceptional Cohort (Predict study) was initiated to bridge the gap of other birth cohorts starting data collection in late pregnancy or at birth, neglecting the critical periconceptional period [3].This hospital-based open cohort is embedded in tertiary care, with couples uniquely recruited in the periconception period.The cohort includes serial consultations and ultrasound scans using advanced virtual reality (VR) and computer-assisted Key Features• The ongoing Rotterdam Periconceptional Cohort (Predict study) is an open cohort, initiated in 2009 to investigate maternal and paternal periconceptional health and their impact on reproduction, pregnancy, and neonatal outcomes.In the pilot phase (2009-10), 233 pregnancies were included.In the study phase (2010-23), 3566 pregnancies (participants aged between 19 and 51 years) and 2891 partners were included.• New is the analysis of periconceptional maternal and paternal biomarkers in subcohorts: renin-angiotensin-aldosterone system (RAAS) components, tryptophan metabolites, homocysteine, C-reactive protein (CRP), hair cortisol/cortisone, cell-free DNA methylation for placental epigenetic profiling, and morphokinetic parameters.• The BEYOND subcohort was embedded to investigate associations between bariatric surgery and maternal, embryonic, fetal, and placental outcomes; and the PROMOTE subcohort explored maternal microbiota, immune responses, and one-carbon metabolism in association with obesity.• First-trimester imaging biomarkers of the uteroplacental vascular skeleton were developed using computer-assisted image processing to assess placental development.Advanced biomarkers were automated using artificial intelligence (AI), with innovations in the four-dimensional Human Embryonic Brain Atlas for spatiotemporal brain analysis.• Users of www.SmarterPregnancy.co.uk were included as a subcohort to assess the effectiveness of personalized digital lifestyle coaching on features of maternal health and embryonic development.