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Eric Steegers

CV

Eric Steegers

 

Eric A.P. Steegers, Professor in Obstetrics and Gynecology

 

Head of the Department of Obstetrics and Gynecology

Erasmus MC – Sophia Children’s Hospital

room SP 4471

Wytemaweg 80

3015 CN Rotterdam – The Netherlands

Tel +31 10 7036886

 

 

Position paper Obstetrics and Prenatal Health (Dutch): http://www.erasmusmc-verloskunde.nl/

 

Personal Statement

My current research interests relate to the Developmental Origins of Health and Disease paradigm involving the complex pathophysiology of cardiovascular and placental related adverse first trimester outcomes and the consequences for fetal and maternal health as well as disease in later life. This work is largely embedded in the Generation R study, a population-based prospective cohort study among 10,000 pregnant women and their children and the Rotterdam Predict Study, an ongoing hospital based periconception cohort study, including embryonic and placental growth trajectories (3D-US and virtual reality) and tissue-specific epigenetic studies. I am one of the PIs of both cohorts. New knowledge from translational research in these areas is being disseminated and translated in evidence-based local and national transmural preconception and early pregnancy programs for improved risk selection and general and personalized interventions with a special emphasis on high risk and socially deprived reproductive target groups, in close collaboration with related fields like Public Health. My mission is to contribute to the primary and secondary prevention of adverse pregnancy outcomes and disease in later life in current and next generations.

 

The recent 5 publications below provide examples of this ambition;

  1. Jaddoe, V.W., de Jonge, L.L., Hofman, A., Franco, O.H., Steegers, E.A. & Gaillard, R. (2014) First trimester fetal growth restriction and cardiovascular risk factors in school age children: population based cohort study. British Medical Journal, 348:doi:10.1136
  2. Temel, S., van Voorst, S.F., Jack, B.W., Denktas, S., Steegers, E.A. (2014) Evidence-based preconceptional lifestyle interventions. Epidemiologic Reviews, 36:19-30.
  3. Steegers-Theunissen, R.P.M., Steegers, E.A.P. (2015) Embryonic health: new insights, mHealth and personalized Patient care. Reproduction Fertility and Development. 16. doi: 10.1071/RD14386.
  4. The Public health Importance of Antenatal Care (EBCOG Position paper No 3). (2015) Facts Views Vis Obgyn. 7:5-6.
  5. Steegers, E.A.P., Geluk, A. (2012) Gezond Zwanger Worden (Achieving Healthy Pregnancy).  Atlas Contact, Amsterdam- Antwerpen; Garant. Antwerpen-Apeldoorn; (2015). Books for the general public.

 

Positions and Employment

2015                 Head of the Department of Obstetrics and Gynecology, Erasmus MC, Rotterdam

2014                 Visiting Professor University of Southampton, England (Faculty of Medicine in the Academic Unit of Human Development and Health).

2004                 Professor in Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam

2002 - 2015       Head of the division Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam

2001 – 2004      Associate professor, subdivision Obstetrics and Prenatal Medicine, Erasmus MC, Rotterdam

1996 – 2001      Associate professor, University Medical Center Nijmegen

1991 - 1996       Senior House Officer, University Medical Center Nijmegen and Queen’s Medical Centre, Nottingham, England

1990                 PhD thesis: Salt and pregnancy. Some aspects of sodium balance during pregnancy and the (patho)physiological implications of dietary sodium restriction, Radboud University Nijmegen

 

Other experience and professional memberships

2009 -               Member of the taskforce ‘Pregnancy and childbirth’ of the ministry of Health

2009 - 2013       Chairman of the advice committee ‘Patient care’ of the Erasmus MC

2011 - 2013       Member of the board of commissioners of the Sophia Pediatrics BV

2012 -               Member of the Resource Management Board of the Baby Bio Bank, Wellbeing for Women, London (Independent Scientific Advisor)

April 2014         Member of an international panel assessing research of the departments Oral Health and Development & Regeneration (acting as chair) of the Group Biomedical Sciences at the KU Leuven (April 23 and 24, 2013)

2014 -               Chief Editor of the Dutch Textbook of Obstetrics and Gynecology

2014 - 2015       Panel chair for the ‘Research Quality Review’ at University College Cork

2014 - 2017       Visiting Professor University of Southampton, England (Faculty of Medicine in the Academic Unit of Human Development and Health).

 

 

Main contribution to science and related publications:

 

1. Embryonic imaging, using technical innovation by virtual reality .

The embryonic period is of crucial importance for future health. Therefore this period has to be examined in detail. Two-dimensional and three-dimensional ultrasound methods are used to examine the embryo and early placenta in detail. The problem with these methods is the fact that the third dimension is not used to its fullest. From the clinical side I headed the process in which the I-Space virtual reality application at the Erasmus MC in Rotterdam (The Netherlands) is increasingly used to examine the embryo and placental vasculature using all available dimensions. Besides visualization possibilities, virtual reality allows accurate semi-automated length and volume measurements of different structures, which was not possible before. These measurements have already leaded to a better understanding of embryonic and placental growth and development. Understanding periconceptional influences on the placental development and embryonic and subsequent periods of childhood and adult life will open a new promising era in healthcare: embryonic health and embryonic medicine. The relatively high cost (about €500.000) and the necessity of a separate room are an obstacle for widespread integration in daily clinical practice. Therefore a desktop system has been developed. This system enables accurate length and volume measurements. The desktop version has an acceptable price (about €12.000) and is more users friendly. At the outpatient clinic of my department of Obstetrics and Gynecology at the Erasmus MC such desktop version has recently been stationed, enabling not only researchers, but also patients to see real 3D embryonic images. This may improve counselling in case of congenital anomalies as well as international collaboration in this field.

Rousian, M., Verwoerd-Dikkeboom, C.M., Koning, A.H., Hop, W.C., van der Spek, P.J., Exalto, N., & Steegers, E.A. (2009) Early pregnancy volume measurements: validation of ultrasound techniques and new perspectives. British Journal of Obstetrics and Gynecology, 116:278-85

Rousian, M., Koning, A.H., van Oppenraaij, R.H., Hop, W.C., Verwoerd-Dikkeboom, C.M., van der Spek, P.J., Exalto, N. & Steegers, E.A. (2010) An innovative virtual reality technique for automated human embryonic volume measurements. Human Reproduction, 25:2210-6

Rousian, M., Hop, W.C., Koning, A.H., van der Spek, P.J., Exalto, N. & Steegers, E.A. (2013) First trimester brain ventricle fluid and embryonic volumes measured by three-dimensional ultrasound with the use of I-Space virtual reality. Human Reproduction, 28:1181-9

Rousian, M., Groenenberg, I.A., Hop, W.C., Koning, A.H., van der Spek, P.J., Exalto, N. & Steegers, E.A. Human embryonic growth and development of the cerebellum using 3-dimensional ultrasound and virtual reality. Reproductive Sciences, 20:899-908

Reus, A.D., Klop-van der Aa, J., Rifouna, M.S., Koning, A.H., Exalto, N., van der Spek, P.J. & Steegers, E.A. (2014) Early pregnancy placental bed and fetal vascular volume measurements using 3D virtual reality. Ultrasound in Medicine and Biology, 40:1796-1803

 

2. Embryonic and fetal health.

I am contributing as a PI to two cohort studies in Rotterdam, the Netherlands. The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. It is designed to identify early environmental and genetic causes of normal and abnormal growth, development and health from fetal life until young adulthood. In total, 9,778 mothers were enrolled in the study. The study focuses on six areas of research: 1) maternal health; 2) growth and physical development; 3) behavioral and cognitive development; 4) respiratory health and allergies; 5) diseases in childhood; and 6) health and healthcare for children and their parents. Main exposures of interest include environmental, endocrine, genetic and epigenetic, lifestyle related, nutritional and socio-demographic determinants. The cohort is also being used to study maternal health after pregnancies complicated by placenta related syndromes such as preeclampsia. Specific expertise is gained regarding fetal sex dependent fetal growth and development as well as maternal adaptation to pregnancy. Completed follow-up programs have included study of the mothers and their children 6 and 9 years after the pregnancy. The second study is the Rotterdam Periconceptional Cohort (Predict) Study. This study was established to examine associations between periconceptional parental gene-environment interactions and molecular biological mechanisms to predict and prevent reproductive failures and adverse pregnancy outcome originating in the periconceptional period. The study is conducted as a tertiary hospital-based prospective open birth cohort at the Erasmus MC, University Medical Center in Rotterdam. Between November 2010 and April 2015, over 1,000 couples were periconceptionally recruited of which the monitoring started in 500 pregnancies before 8 weeks of gestation and in 300 pregnancies between 8-13 weeks of gestation. Detailed first trimester data, blood sampling and serial ultrasound examination of the embryo was obtained and follow-up of the infants up to one year of age.

Mook-Kanamori, D.O., Steegers, E.A., Eilers, P.H., Raat, H., Hofman, A. & Jaddoe, V.W. (2010) Risk factors and outcomes associated with first-trimester fetal growth restriction. JAMA-Journal of the American Medical Association, 303:527-534

Bouwland-Both, M.I., Steegers-Theunissen, R.P., Vujkovic, M., Lesaffre, E.M., Mook-Kanamori, D.O., Hofman, A., Lindemans, J., Russcher, H., Jaddoe, V.W. & Steegers, E.A. (2013) A periconceptional energy-rich dietary pattern is associated with early fetal growth: the Generation R study. British Journal of Obstetrics and Gynecology,120:435-45

Van Uitert, E.M., van der Elst-Otte, N., Wilbers, J., Exalto, N., Willemsen, S., Eilers, P., Koning, A.H., Steegers, E.A. & Steegers-Theunissen, R.P. (2013) Periconception maternal characteristics and embryonic growth trajectories: The Rotterdam predict study. Human Reproduction, 28:1753-61

Gaillard, R., Steegers, E.A., Tiemeier, H., Hofman, A., Jaddoe, V.W. (2013) Placental vascular dysfunction, fetal and childhood growth, and cardiovascular development: The generation R study. Circulation, 128:2202-10.

Brown, Z.A., Schalekamp-Timmermans, S., Tiemeier, H.W., Hofman, A., Jaddoe, V.W. & Steegers, E.A. (2014) Fetal sex specific differences in human placentation: A prospective cohort study. Placenta, 35:359-64.

3. Societal valorization of academic knowledge to reduce discrepancies in perinatal health.

 

There is convincing evidence that improving perinatal health can reduce inequalities in health later in life. In order to make this happen, I believe that societal valorization programs should be initiated and supported by both universities and government bodies. Risk accumulation of both medical and non-medical modifiable risk factors contribute to increased perinatal mortality Effects of poverty and deprivation on perinatal health are substantial and are seen across all immigrant and native European and US communities. Societal valorization therefore should result in transdisciplinary obstetric care innovation involving programs of preconception care and broadened antenatal care to align with what we know about the interrelated and complex roles that (non)medical factors play in determining perinatal health outcomes. In order to be able to do so, I feel that such programs should integrate pregnancy-related care with public health initiatives and youth care particularly in the more disadvantaged sectors of our communities. Taking this action has the potential to interrupt cycles of deprivation and to address inequalities at their source. I have initiated both municipal as well as national programs with that purpose.

 

Timmermans, S., Bonsel, G.J., Steegers-Theunissen, R.P., Mackenbach, J.P., Steyerberg, E.W., Raat, H., Verbrugh, H.A., Tiemeier, H.W., Hofman, A., Birnie, E., Looman, C.W., Jaddoe, V.W. & Steegers, E.A. (2011) Individual accumulation of heterogeneous risks explains perinatal inequalities within deprived neighbourhoods. European Journal of Epidemiology, 26:165-180.

van der Zee, B., de Beaufort, I., Temel, S., de Wert, G., Denktaş, S. & Steegers, E. (2011) Preconception care: an essential preventive strategy to improve children's and women's health. Journal of Public Health Policy, 32:367-379.

Denktaş, S., Bonsel, G.J., Van der Weg, E.J., Voorham, A.J., Torij, H.W., De Graaf, J.P., Wildschut, H.I., Peters, I.A., Birnie, E. & Steegers, E.A. (2012) An urban perinatal health programme of strategies to improve perinatal health. Maternal Child Health Journal, 16:1553-1558.

 

de Graaf, J.P., Steegers, E.A., Bonsel, G.J. (2013) Inequalities in perinatal and maternal health. Current Opinion in Obstetrics & Gynecology, 25:98-108.

 

Denktaş, S., Poeran, J., van Voorst, S.F., Vos, A.A., de Jong-Potjer, L.C., Waelput, A.J.M., Birnie, E., Bonsel, G.J. & Steegers, E.A.P. (2014) Design and outline of the Healthy Pregnancy 4 All Study. BMC Pregnancy and Childbirth, 14:253.

 

Link to complete publication list in pubmed:

http://www.ncbi.nlm.nih.gov/sites/myncbi/1-wi26fN68aAR/bibliograpahy/40991093/public/?sort=date&direction=descending

 

 

Ongoing research support:

IMPROVED: Improved Pregnancy Outcomes by Early Detection; personalized medicine for pregnant women: novel metabolomic and proteomic biomarkers to detect pre-eclampsia and improve outcome (FP7-Health-2012-Innovation-1; European collaborative project; Erasmus MC Work package leader, 600.000 euro)

Academische Werkplaats Zwangerschap & Geboorte Regio Zuidwest Nederland (The Netherlands Organization for Health Research and Development, ZonMw, October 2012, 250.000 euro)

Joining Forces against joint risks: structured preventive antenatal and postnatal care for vulnerable families in the Southwest of the Netherlands (The Netherlands Organization for Health Research and Development, ZonMw, October 2012, 250.000 euro)

Evaluation of birth centre care in the Netherlands (The Netherlands Organization for Health Research and Development, ZonMw, October 2012, 750.000 euro)

SlimmerZwanger: An e-health personal coaching program to improve nutrition and lifestyle of future parents (Achmea Health Insurance, September 2011, 118.900 euro)

Ethical issues in preconception counselling (The Netherlands Organization for Health Research and Development, ZonMw, June 2013, 200.000 euro)

Healthy Pregnancy 4 All -2. Innovation and integration of antenatal- and youth care (Ministry of Health, 2014-2017, 2.390.928 euro)

Working conditions and healthy pregnancy (The Netherlands Organization for Health Research and Development, ZonMw, June 2014, 100.000 euro)

Scientific evaluation of the program ‘Mothers of Rotterdam’, This program focuses on highly vulnerable pregnancy pregnant women and aims to increase the chances of a healthy pregnancy, safe bonding period and a good start for the child.Het programma wordt uitgevoerd door Bureau Frontlijn, een uitvoeringsorganisatie van de Gemeente Rotterdam. The program is implemented by Frontline Agency, an executive agency of the City of Rotterdam (Foundation The Distant Mountains - knowledge and capital for bold ideas ,  Stichting Verre Bergen Rotterdam, June 2015, 1.500.738 euro; total program 7.507.634 euro).