The impact of maternal lifestyle factors on periconception

February 2, 2019

Research looking at the main risk factors important to reproductive health shows that these issues often form in the periconception period.The periconception environment is determined by maternal pre-existing medical conditions and modifiable lifestyles, including smoking, diet and body mass index. There is growing evidence about the impact of these lifestyle factors on fertility in women of reproductive age.

Poor lifestyle factors are common among women of childbearing age and thus are a major public health concern. Poor lifestyle factors are associated with adverse pregnancy outcomes such as miscarriage, longer time to become pregnant and restricted embryotic growth. There following lifestyle factors where found to influence the ability to have a live birth.



There is strong evidence indicating that cigarette smoke contains toxic chemicals that affect the follicular mircoenvironment which results in a shorted time period when a woman is able to become pregnant. Smoking also decreases ovarian function and reduces ovarian reserve compared to non-smokers. Compounds in cigarette smoke also impairendometrial maturation, implantation and early placentation. This could explain the significantly higher risk of miscarriage in the first trimester. This association was higher depending on the number of cigarettes smoked per day.



Higher rates of alcohol intake during pregnancy has been reported to have associations to early pregnancy failure and decreased ability to become pregnant, therefore women who consume alcohol may take longer to become pregnant. Alcohol can also result in in irreversible damage to the placenta and organs of the developing embryo. Adverse pregnancy outcomes such as stillbirth, preterm birth, intrauterine growth restriction, fetal alcohol syndrome and the risk of miscarriage also increase from alcohol consumption.



Caffeine could affect female reproduction by increasing estrogen production and thereby affecting ovulation and increasing of the time to. Caffeine is known to pass the placental barrier which could affect embryotic and placental growth and development. The rate of caffeine metabolism also decreases during pregnancy, leading to higher exposure of the embryo.



Diet is known to affect the ability to have a life birth. In women of reproductive age, the adherence to the Mediterranean diet (characterized by high consumption of vegetables, fish, fruits, poultry, low-fat dairy products and olive oil reduces the risk of weight gain and insulin resistance and increases pregnancy rates by 40% in couples undergoing IVF/ICSI. Olive oil is an important source of linoleic acid, which is known to improve the reproductive process. Folate, and other vitamins, such as B6 and B12 could also play a role in biological processed during the periconception period. Lower miscarriage rates were also found with folic acid and/or multivitamin supplement use. Vitamin D is also an important contributor regulating the synthesis of several hormones which are essential in maintaining the regulation of utero-placental blood flow.


BMI and physical activity:

Being overweight or obese is associated with an increased time to become pregnant and the ability to have a live birth, while also increasing the risk of miscarriage.

A healthy amount of physical activity can be beneficial by leading to relaxation and reducing stress. Vigorous physical activity, however, is known to be potentially harmful by exceeding the energy demand over dietary energy intake, eventually leading to menstrual abnormalities and subsequently, a prolonged time to pregnancy may occur.



Modifiable maternal lifestyle factors affect periconception outcomes. If couples planning a pregnancy are more aware and supported to adopt healthy lifestyles during the periconceptional ‘window of opportunity’, short-term reproductive health as well as health in later life and even of future generations can be further improved.


For more information about planning a pregnancy:


For more information about preconception:



  1. Reproductive BioMedicine Online. ‘The impact of maternal lifestyle factors on periconception outcomes: a systematic review of observational studies. Volume 38, Issue 1. Pages 77-94. Accessed January 2019.