Annick Bogaerts

Introduction Preterm birth and small-for-gestational-age (SGA) infants remain major contributors to neonatal morbidity, mortality and healthcare costs. Twin pregnancies account for a disproportionate share of these adverse outcomes, representing 18%–24% of all preterm births in Europe. Despite this high-risk profile, effective preventive strategies for twin pregnancies remain limited and mainly target cervical length. Emerging evidence suggests that maternal lifestyle factors, including diet, physical activity and stress management, may prolong gestational age and improve fetal growth. Methods and analysis The LIFEstyle intervention to improve TWIN pregnancy (LIFETWIN) - study is a multicentre, open-label, randomised controlled trial. A total of 274 women with dichorionic twin pregnancies will be recruited across 15 sites in Belgium. The full trial will be preceded by an integrated pilot study conducted at four sites to assess feasibility using the RE-AIM framework. Participants will be randomised to standard care or a lifestyle intervention in addition to standard care. The intervention consists of eight midwife-led sessions between gestational weeks 16 and 36, focusing on a Mediterranean-type diet, physical activity, mindfulness and prenatal multivitamin supplementation. Data are collected at baseline, in late pregnancy, at delivery and at 6 weeks postpartum, using clinical records, physical examinations and validated questionnaires. The primary outcome is gestational age at delivery. Secondary outcomes include neonatal birth weight, SGA status, neonatal morbidity and mortality, neonatal intensive care unit admission and length of stay, maternal gestational weight gain, postpartum weight and quality of life. The primary outcome, gestational age at delivery, will be analysed using a linear mixed-effects model, accounting for study-site effects and potential clustering by intervention midwife within the intervention arm. Secondary outcomes will be analysed using models appropriate to the outcome type, including linear mixed models, generalised mixed models and frailty models. Ethics and dissemination The trial has been approved by the central ethics committee of Leuven (identification number S68251) and by the local ethics committees of each participating site. The trial will be conducted in accordance with the Declaration of Helsinki. All results, whether positive, negative or inconclusive, will be disseminated at national or international scientific meetings and published in peer-reviewed scientific journals. Trial registration number NCT07270640.

Maintaining a healthy lifestyle during pregnancy is important for maternal and child health. Partners can play a key role in supporting healthy nutrition and physical activity behaviours, yet there is currently no comprehensive overview of their experiences in providing such support. This scoping review aimed to explore partners' the barriers and facilitators in supporting healthy nutrition and physical activity behaviours during pregnancy. A scoping review was conducted following the PRISMA guidelines and the JBI methodology. Searches were conducted in six databases. Studies were included if they explored partners' experiences in supporting healthy nutrition and/or physical activity during pregnancy. Data were extracted independently by two reviewers and barriers and facilitators were mapped onto the Capability, Opportunity, Motivation-Behaviour model and the Theoretical Domains Framework. Three overarching themes emerged: the need for knowledge, information, and practical guidance; the influence of relationship, household, and social contexts on support behaviours and the importance of partners' perceptions of their role during pregnancy. A key finding was that partners' sense of responsibility during pregnancy emerged as a central determinant of support, with greater involvement reported among those who viewed pregnancy as a shared responsibility. Actively involving partners in antenatal care may enhance their capacity to support healthy nutrition and physical activity behaviours during pregnancy through tailored information and guidance.

Maintaining a healthy lifestyle during pregnancy is important for maternal and child health. Partners can play a key role in supporting healthy nutrition and physical activity behaviours, yet there is currently no comprehensive overview of their experiences in providing such support. This scoping review aimed to explore partners’ the barriers and facilitators in supporting healthy nutrition and physical activity behaviours during pregnancy. A scoping review was conducted following the PRISMA guidelines and the JBI methodology. Searches were conducted in six databases. Studies were included if they explored partners’ experiences in supporting healthy nutrition and/or physical activity during pregnancy. Data were extracted independently by two reviewers and barriers and facilitators were mapped onto the Capability, Opportunity, Motivation–Behaviour model and the Theoretical Domains Framework. Three overarching themes emerged: the need for knowledge, information, and practical guidance; the influence of relationship, household, and social contexts on support behaviours and the importance of partners’ perceptions of their role during pregnancy. A key finding was that partners’ sense of responsibility during pregnancy emerged as a central determinant of support, with greater involvement reported among those who viewed pregnancy as a shared responsibility. Actively involving partners in antenatal care may enhance their capacity to support healthy nutrition and physical activity behaviours during pregnancy through tailored information and guidance.

Maintaining a healthy lifestyle during pregnancy is important for maternal and child health. Partners can play a key role in supporting healthy nutrition and physical activity behaviours, yet there is currently no comprehensive overview of their experiences in providing such support. This scoping review aimed to explore partners' the barriers and facilitators in supporting healthy nutrition and physical activity behaviours during pregnancy. A scoping review was conducted following the PRISMA guidelines and the JBI methodology. Searches were conducted in six databases. Studies were included if they explored partners' experiences in supporting healthy nutrition and/or physical activity during pregnancy. Data were extracted independently by two reviewers and barriers and facilitators were mapped onto the Capability, Opportunity, Motivation-Behaviour model and the Theoretical Domains Framework. Three overarching themes emerged: the need for knowledge, information, and practical guidance; the influence of relationship, household, and social contexts on support behaviours and the importance of partners' perceptions of their role during pregnancy. A key finding was that partners' sense of responsibility during pregnancy emerged as a central determinant of support, with greater involvement reported among those who viewed pregnancy as a shared responsibility. Actively involving partners in antenatal care may enhance their capacity to support healthy nutrition and physical activity behaviours during pregnancy through tailored information and guidance.

Maintaining a healthy lifestyle during pregnancy is important for maternal and child health. Partners can play a key role in supporting healthy nutrition and physical activity behaviours, yet there is currently no comprehensive overview of their experiences in providing such support. This scoping review aimed to explore partners' the barriers and facilitators in supporting healthy nutrition and physical activity behaviours during pregnancy. A scoping review was conducted following the PRISMA guidelines and the JBI methodology. Searches were conducted in six databases. Studies were included if they explored partners' experiences in supporting healthy nutrition and/or physical activity during pregnancy. Data were extracted independently by two reviewers and barriers and facilitators were mapped onto the Capability, Opportunity, Motivation-Behaviour model and the Theoretical Domains Framework. Three overarching themes emerged: the need for knowledge, information, and practical guidance; the influence of relationship, household, and social contexts on support behaviours and the importance of partners' perceptions of their role during pregnancy. A key finding was that partners' sense of responsibility during pregnancy emerged as a central determinant of support, with greater involvement reported among those who viewed pregnancy as a shared responsibility. Actively involving partners in antenatal care may enhance their capacity to support healthy nutrition and physical activity behaviours during pregnancy through tailored information and guidance.

Maintaining a healthy lifestyle during pregnancy is important for maternal and child health. Partners can play a key role in supporting healthy nutrition and physical activity behaviours, yet there is currently no comprehensive overview of their experiences in providing such support. This scoping review aimed to explore partners' the barriers and facilitators in supporting healthy nutrition and physical activity behaviours during pregnancy. A scoping review was conducted following the PRISMA guidelines and the JBI methodology. Searches were conducted in six databases. Studies were included if they explored partners' experiences in supporting healthy nutrition and/or physical activity during pregnancy. Data were extracted independently by two reviewers and barriers and facilitators were mapped onto the Capability, Opportunity, Motivation-Behaviour model and the Theoretical Domains Framework. Three overarching themes emerged: the need for knowledge, information, and practical guidance; the influence of relationship, household, and social contexts on support behaviours and the importance of partners' perceptions of their role during pregnancy. A key finding was that partners' sense of responsibility during pregnancy emerged as a central determinant of support, with greater involvement reported among those who viewed pregnancy as a shared responsibility. Actively involving partners in antenatal care may enhance their capacity to support healthy nutrition and physical activity behaviours during pregnancy through tailored information and guidance.

Introduction: Pregnancy concurrent with incretin‐based medications is contraindicated due to unknown risk of teratogenicity, as is breastfeeding. The aim of this systematic scoping review was to investigate potential risks and benefits of incretin‐based medications in relation to preconception, pregnancy, and postnatal health, and to propose expert guidelines for clinical practice. Methods: An international expert multidisciplinary group was formed. Research questions relevant to women's reproductive health and incretin‐based medications were refined collaboratively, utilizing a lifecourse approach. A systematic search was undertaken on July 23, 2025, across several databases and grey literature sources. Primary data from human studies were prioritized above animal studies. Titles, abstracts, and full text articles were screened independently by two authors. Data were extracted by two people independently using a pre‐defined proforma and synthesized narratively. Consensus recommendations were made. Results: Thirty‐four articles were included in the evidence synthesis: 11 randomized trials, nine observational studies, two pharmacovigilance reviews, nine case reports/series, two animal studies, and one ex vivo study. No qualitative studies were identified. Evidence was found for 18/32 (56.3%) research questions. Most studies related to preconception or pregnancy usage; two addressed contraception, and one was about lactation. The sample size of exposed pregnancies ranged from 1 to 4267. Three studies reported exposure throughout pregnancy. Three studies investigated postpartum usage. One (animal) study had offspring data beyond birth. No studies reported an increase in congenital anomalies. Conclusion: Clinical practice and research recommendations were made based on current available evidence and evidence gaps, encompassing contraception, preconception, nutritional, pregnancy monitoring, lactation, and longer‐term outcomes.

Endocrine-disrupting chemicals (EDCs) represent a threat for the ecosystem and human health. Exposure routes include modifiable exposures, such as choice of food or cosmetics but also daily habits such as airing the room. However, current attempts to reduce modifiable exposure often rely on knowledge provision and awareness-raising campaigns. This is the case even though human behaviour, decision making and habits change have been studied for a long time, and numerous psychological theories demonstrate that the transition from awareness of a health threat to actually change daily behaviour is not straightforward. This paper calls for interventions on EDCs exposure reduction to build on solid understanding of human behaviour and use of behaviour change techniques to achieve significant impact. We illustrate how this can be done by presenting the HYPIEND project, a multicomponent behavioural intervention designed to help pregnant women and prepubertal children (and their parents) to reduce their modifiable exposure to EDCs in these sensitive periods. HYPIEND relies on theoretical models such as the Health Action Process Approach (HAPA) model, motivational interviewing techniques, and broader support through partners (for pregnant women) and the school environment (for children) through a school-wide project built on the School Wide Positive Behavioural Interventions Supports.

Background: Safety data for most medications in pregnancy remain limited, yet pharmacological treatment is often necessary. Evidence on real‐world medication use in pregnancy including over‐the‐counter products and folic acid is scarce, especially in Belgium. Methods: We conducted a drug utilization study using self‐reported data from BELpREG, a prospective, web‐based pregnancy registry established in November 2022. Pregnant individuals aged ≥ 18 years receiving healthcare in Belgium can enrol voluntarily at any stage in pregnancy and complete online questionnaires at enrolment and every four weeks until delivery. All participants with follow‐up beyond the first trimester were included, and trimester‐specific cohorts were constructed based on completion of questionnaires after each trimester. Data were extracted in July 2025. Results: This study included 2096 participants, of whom 1767 were followed through trimester 2 and 1136 through trimester 3. Median gestational age at enrolment was 16 weeks. Prevalence estimates of medication use were 80.2% in the six months before conception, 85.8% in trimester 1, 92.0% in trimester 2, and 94.9% in trimester 3. The most common classes were analgesics, vaccines, antihistamines, antianemic preparations, and drugs for acid‐related disorders. Paracetamol was most frequently used (35.4% in trimester 1), typically short term (median 3 days), followed by doxylamine‐pyridoxine (26.7% in trimester 1). Folic acid supplementation was nearly universal, though only 59.9% met national guideline‐concordant criteria. Maternal vaccine uptake was substantial but incomplete, with 66.5% receiving pertussis, 43.7% influenza, and 24.4% COVID‐19 vaccination. Exposure to potentially inappropriate or teratogenic medications was rare. Conclusions: Medication use during pregnancy in Belgium was nearly universal, with high use of paracetamol and doxylamine‐pyridoxine. Folic acid and vaccine uptake were substantial, but often not guideline‐concordant.

The BELpREG registry in Belgium collects self-reported real-world data on perinatal medication use and mother-infant outcomes. Given the importance of self-reported data for pregnancy safety studies, this study aims to assess the reliability of maternal health and mother-infant outcome data reported in BELpREG. We compared self-reported maternal health and mother-infant outcomes in the BELpREG registry with medical record data from gynaecologists, general practitioners, and midwives. Participants included pregnant women enrolled in BELpREG, aged 18 years or older, who delivered between November 2022 and April 2024 and had medical record data provided by at least one healthcare professional (HCP). Comparisons for continuous variables such as pre-pregnancy body mass index (BMI), gestational age at delivery, and infant metrics at birth were analysed using intraclass correlation coefficients (ICCs). For dichotomous and categorical variables, including pregnancy complications, delivery characteristics, and hospital admissions, we used Cohen's Kappa and observed proportions of positive and negative agreement. This study included 175 participants with available medical record data. Medical records were mostly returned by gynaecologists (40%) and midwives (25.7%). Reliability was high for pregnancy complications, onset, and mode of delivery. Gestational age showed almost perfect concordance (ICC 0.99). Infant outcomes, including birth metrics and Apgar scores, were highly reliable (ICC > 0.90), with almost perfect categorisation into birth weight percentiles (Cohen's Kappa 0.97). Self-reported maternal BMI exhibited moderate reliability as a continuous measure (ICC 0.75), but almost perfect agreement when categorised (Cohen's Kappa 0.89). The low prevalence of hospital admissions, delivery complications, infant complications, postpartum complications, and birth defects limited the assessment of these outcomes. The BELpREG registry demonstrated high agreement between self-reported and HCP-reported data for most maternal health and mother-infant outcomes, supporting its use in future pregnancy safety studies.