The Center for Pregnancy & Childhood is a multidisciplinary center for patient care, education and research to improve health and well-being for pregnant women, parents-to-be and children by an integrated approach of basic, epidemiological and clinical research from a life course perspective.
Research Activities
The research in this ACE is characterized by integration of basic, epidemiological and clinical research using a life-course perspective and a translational approach.
Many PI's already collaborate on various research topics related to early origins of health, reproductive health, developmental and molecular biology, and public health. These successful collaborations will be expanded to integrate research on preconception, pregnancy and childhood into an overarching theme that covers the full spectrum from fundamental research on development, molecular mechanisms and chronobiology, via epidemiological research on early determinants of later health, and clinical research on reproduction and neonatal/child health, to translation of findings into clinical and public health practice.
This can only occur in a setting of strong interdisciplinary collaboration, which this ACE provides. We will optimally use existing research infrastructures (e.g. Generation R, Predict Study), and also set up new studies using state-of-the-art methods and techniques. Strong collaboration exists with national and international institutes, including Groningen University, Harvard University, the universities of Oxford, Bristol and Cambridge, Ludwig-Maximilians-University Munich, and many others.
These collaborations often take the form of large consortia, in which PI's of this ACE take leading roles. We will build upon and expand these collaborations to make optimal use of the expertise, skills, and resources.
Collaborations
Strong collaboration exists with national and international institutes, including Groningen University, Harvard University, the universities of Oxford, Bristol and Cambridge, Ludwig-Maximilians-University Munich, and many others. These collaborations often take the form of large consortia, in which PI’s of this ACE take leading roles.
Contributions
The participating PI's of this ACE contribute to education for bachelor, research master and PhD students. Research training is largely embedded in the Erasmus MC Research Schools, including Netherlands Institute of Health Sciences (nihes), Medical Genetics Center (MGC) and Molecular Medicine (MolMed).
All research master and PhD students are embedded in one of these research schools. The clinical PIs in this ACE provide training and education for residents and receive regular feedback based on SETQ or D-RECT . A summary of education activities is available at the end of this form. This ACE has developed a new Maternal and Child Health Research training program for MSc, MD, DSc and PhD students, embedded in the Erasmus MC Graduate School.
All students start with the Erasmus Summer Programme and introductory courses on methodology and statistics. After this common trunk, students enter a customized program on Maternal and Child Health research with courses on population health (life‐course, perinatal, pediatric epidemiology, reproductive medicine) and on molecular and developmental biology and genetics. Various courses are already available in the Erasmus Research Schools COEUR, MolMed, Neuroscience, and NIHES. This programme will thus integrate aspects of basic science, population science, clinical topics and methodology, all related to preconception, pregnancy and child health and it will make optimal use of existing infrastructures.
The program will welcome local, national and international students. Feedback from evaluations, visitation and audits will be evaluated and implemented where needed and possible. Currently, approximately 30 international students are working in this ACE.
Care Activities
Multidisciplinary tertiary care for pregnant women, parents-to-be and their children is provided starting from reproductive medicine, to preconception and embryonic health, and fetal and childhood outcomes. The main clinical groups are the Departments of Child & Adolescent Psychiatry, Neonatology, Obstetrics & Gynecology, and Pediatrics. Patients are discussed in multidisciplinary meetings. Dedicated follow-up programs are available for pregnant women, parents-to-be and children with specific care needs, including patients who need specialized care according to the TRF portal. There is close collaboration with hospitals in the Rotterdam area. Multidisciplinary care programs will be developed with combined care paths ("Zorgpaden") e.g. combined maternal and child follow-up. Within the new sector obstetrics & neonatology integrated programs for critical care for pregnant women and their offspring will be developed. ROBIJN labels 80% of care in this ACE as academic. This ACE participates in the "Value based health care" program. Outcome measures are defined with patients, measured and results are used for improvement of individual care. This process will be tracked and monitored. Feedback from visitations and audits will be implemented to improve quality of care. Due to continuous cross-talk between research and practice, clinical questions can be translated into research, and research findings translated into practice.
Societal Relevance to Research, Education and Patient Care
The Departments of Child & Adolescent Psychiatry, Epidemiology, Generation R, Obstetrics & Gynecology, Pediatrics, and Public Health are heavily involved in preventive population care programs together with the City of Rotterdam and the Municipal Health Service, including Generation R, Healthy Pregnancy 4 All, and "Klaar voor een Kind". These programs are funded by ZonMw or the Ministry of Health, Welfare and Sports and considered by local and national governments as great examples of collaborations between university and city.
The programs translate research findings into population health strategies focusing on preconception care, perinatal health, obesity, asthma and behavior. Within this ACE, dedicated multidisciplinary groups will be formed focused on specific outcomes to create additional programs with the largest population health effects. Multiple PI's have been involved in guidelines development and actively interact with patient organizations. Also, several PIs participate in committees of the Dutch Health Council. As described, this ACE has developed a new Maternal and Child Health Research training program. Multiple PIs have contributed to the Rotterdam "Science Café". Several guidelines, reference charts, and textbooks have been initiated and developed by the involved investigators.
Viability of Research, Education and Patient Care
We are continuously and actively scouting talented individuals in clinical care, research and education and have a focus on keeping them within Erasmus MC. Through our education activities, both in the specific Maternal and Child Research training program and in the existing structures of medical and postgraduate education, we have regular contact with young talented individuals that have an interest in this field. Through research or clinical internships, we are able to explore and nourish their talents and to recruit them to our ACE. This ACE has a clear layered structure, with participants from multiple backgrounds, with various areas of expertise, and at various career stages. Regular interaction between the members of the ACE will allow sharing of knowledge and skills and maintenance of continuity.
The progress of PhD students will be monitored according to the Training and Supervision Plan of Erasmus MC. ACE participants at various levels will be encouraged to enroll in the relevant talent programs of Erasmus MC, such as the female career development, mentoring, and personal leadership programs.
Talents are encouraged and supported to perform international visits to one of the main international collaborating groups (Harvard University, Oxford University, Bristol University, Ludwig-Maximilians-University Munich) or any other top university. Several PhDs and postdoctoral students already visited one of these groups. Many PIs are involved in international consortia, in which the PhD and postdoctoral students have a major role.
Key and relevant publications of the last five years
- Joubert et al. Nat Commun 2016. IF: 11.3 (Felix, Steegers, Jaddoe, Duijts)
- Steegers-Theunissen et al. Int J Epidemiol 2016. IF: 7.5 (Steegers-Theunissen, Koning, Laven, Reiss, Steegers)
- Van Dycke et al. Curr Biol 2015. IF: 8.9 (Van der Horst)
- Day et al. Nat Commun 2015. IF: 11.3 (Laven)
- Barakat et al. Mol Cell 2014. IF 13.9 (Gribnau)
- Jaddoe et al. BMJ 2014. IF: 19.9 (Jaddoe, Steegers)
- St Pourcain et al. Nat Commun 2014. IF: 11.3 (Verhulst, Jaddoe)
- Gontan et al. Nature 2012. IF: 38.1 (Gribnau)
- Taal et al. Nat Genet 2012. IF: 31.6 (Steegers, Jaddoe)
- Brusselle G et al. Lancet 2011. IF: 44.0 (Brusselle)
PhD theses of the last five years
- Van Dycke, 2016: Working around the clock. Adverse health effects of circadian rhythm disturbance. (Van der Horst)
- Mous, 2015: The distracted brain. (Verhulst)
- Vos, 2015: Strategies to reduce perinatal health inequalities. The Healthy Pregnancy 4 All Study. (Steegers)
- Plaisier, 2014: MR Imaging of the Preterm brain: safer better faster stronger. (Reiss)
- Bouwland-Both, 2014: Early Human Fetal Growth. (Steegers-Theunissen, Jaddoe)
- Louwers, 2014: Polycystic Ovary Syndrome: rom phenotype to genotype. (Laven)
- Gaillard, 2014: Cardiovascular health in pregnant women and children. (Jaddoe and Steegers) Cum Laude.
- Sonnenschein-van der Voort, 2014: Fetal and infant origins of childhood asthma. The Generation R Study. (Duijts)
- Van Grieken, 2013: Promotion of a healthy weight and lifestyle among children. The ‘Be Active, eat right’ study. (Raat)
- Barakat, 2012: Living with two X chromosomes: of mice and women. (Gribnau)