LAUSR

Generation R is a unique population-based prospective cohort study ( www.generationr.nl ). The infrastructure has been established in 2002 by recruiting the first cohort consisting of n = 10.000 pregnant women. These mothers and children are currently participating in our 14 years follow-up visit. In 2017 Generation R launched a new large cohort study: Generation R Next. This study is unique since it aims to study the health and lifestyle of mothers before pregnancy; preconceptionally. Since 2006 over 80 PhD theses and 700 peer-reviewed scientific papers have been published. Generation R represents the perfect example of this year’s theme of the ISSHP/ISOM meeting 2018. In our population based pregnancy population we have highlighted the importance of first trimester sFlt-1, PLGF and PAI-2 concentrations in relation to placental function and the risks for preeclampsia and fetal growth restriction. We were among the first to show the importance of fetal sex in placental and maternal adaptation to pregnancy with sexual dimorphic differences in the occurrence of preeclampsia. These studies were accomplished through collaboration within the Global Pregnancy Collaboration (CoLab). Our data collection extends to maternal and child follow-up’s after pregnancy which includes women with previous hypertensive pregnancy disorders. We are now conducting a brain MRI study among women who’s index pregnancy was complicated by preeclampsia 14 years ago. We previously reported on the altered microvasculature, atherogenic lipid profile, increased left ventricular mass and higher blood pressures in those women 6 years after the pregnancy which eventually lead to an almost sevenfold increased risk for chronic hypertension. This indicates that also mild hypertensive pregnancy disorders pose a risk for cardiovascular disease and therefore these women should be offered long-term cardiovascular follow-up. By this means results from the Generation R Study contribute to the development of strategies for optimizing health and healthcare for pregnant women and their children.