Work

Maternal exposome and risk of very preterm birth or fetal growth restriction: a case–control study

Year: 2025

Type: article

Abstract: Maternal exposome-including environmental, behavioral and social exposures-is a known determinant of pregnancy complications, but its impact on severe outcomes like very preterm birth (VPB) and late fetal growth restriction (late FGR) remains unclear. A case-control study was conducted in Rome between 2023 and 2025, as part of the project “Valutazione dell'esposoma nei primi 1000 giorni in coorti di nati in aree ad elevata antropizzazione e attuazione di interventi per la riduzione del rischio”. Cases were singleton pregnancies ending in spontaneous delivery before 32 weeks or FGR at 32-36 weeks; controls were low-risk singleton pregnancies delivered at 37-41 weeks. Exposome variables, including lifestyle, occupational risks and social determinants, were collected through a validated 76-item questionnaire covering the pre-conception period and each trimester. Logistic regression adjusted for maternal age maternal age, gestational weight gain, and number of children was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals. We enrolled 158 women, including 63 cases and 95 controls. Physical activity during pregnancy was reported by 89% of participants. Walking outdoors weekly in the first (aOR 0.20, 95%CI 0.05-0.84) and third trimester (aOR 0.22, 95%CI 0.06-0.73) was significantly associated with lower risk of VPB or FGR. Gym activity during the first trimester also showed an inverse association (aOR 0.22, 95%CI 0.05-0.92). Smoking and alcohol use were reported by 28% and 53% of women before pregnancy, but no significant association with the outcome was found. These results suggest a potential protective role of moderate physical activity during pregnancy against the risk of VPB and FGR. Larger studies with more precise exposure measurements are needed to strengthen the evidence and support effective preventive strategies in maternal health. Project conducted with the technical and financial support of the Italian Ministry of Health-PNC. Key messages • Healthy behaviours, including moderate physical activity, during pregnancy are associated with reduced risk of very preterm birth and late fetal growth restriction. • Addressing the maternal exposome and promoting healthy behaviours before and during pregnancy can strengthen prevention efforts and reduce the burden of serious obstetric complications.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckaf161.1677