Table 1 Definition of primary and secondary outcomes of the APROPOS-II study

Pregnancy preparation

Level of pregnancy planning

London Measure of Unplanned Pregnancies (LMUP) [21]

PCC health seeking behaviour

Acquired PCC-information through the internet, books, journals, folders or family & friends.

PCC-consult

A consultation provided by a healthcare provider.

Modifying lifestyle behaviours & risk factors

Fruit intake

≥ 2 pieces of fruit a day [22]

Vegetable intake

≥ 200 g of vegetables a day [22]

Caffeine intake

≤ 1 caffeine-containing beverage [22]

Exercising

≥ 150 min per week moderate or heavy intensive exercise, spread over various days [23]

Smoking

No smoking [5, 24]

Alcohol intake

No alcohol intake [5, 24]

Folic acid usage

≥400 microgram per day, 4 weeks preconceptionally until 10 weeks gestation [5, 24]

Medication usage

Risk-free medication [5]

Psychological distress

A stable emotional state [5]

Vaccination status

Vaccination status should be discussed with special attention to rubella, measles and whooping cough. Based on individual assessment of antibody titres; (re)vaccinations can be considered [24]

Working conditions

Avoid contact with harmful working conditions [5]

Prenatal outcomes

Miscarriage

Loss of pregnancy before 24 weeks [25].

Gestational Diabetes (GDM)

Diagnosed by a 75-g oral glucose tolerance test (OGTT) as the presence of either a fasting glucose level of ≥7.0 mmol/L (126 mg/dl) or a glucose level of ≥7.8 mmol/L (140 mg/dl) after two hours [26, 27]

Pregnancy-induced hypertension (PIH)

New onset of hypertension (≥ 140 mmHg systolic and/or ≥ 90 mmHg diastolic blood pressure) after 20 weeks gestation measured on at least two occasions four hours apart [28, 29]

Pre-eclampsia (PE)

PIH accompanied by proteinuria (≥300 mg in 24 h) [29, 30]

Spontaneous preterm birth

Delivery with spontaneous onset before 37 weeks of gestation [31].

Referral to secondary care

If complications occur or threaten to occur, the midwife will refer the woman to the obstetrician who will take over the care for as long as deemed necessary [32].

Birth outcomes

Mode of delivery

Spontaneous vaginal delivery, assisted vaginal delivery, or caesarean section [33].

Referral to secondary care

If complications occur or threaten to occur, the midwife will refer the woman to the obstetrician who will take over the care for as long as deemed necessary [32].

Neonatal outcomes

Small for gestational age (SGA)

Birth weight < 10th percentile, based on Dutch national reference curves adjusted for parity, gestational age, sex and ethnicity [34].

Congenital anomalies

Structural-morphological, functional and/or biochemical-molecular defects

present at birth [35].

APGAR- score

A score is a sum of the values assigned to the infant at 1 and 5 min of life, with a score of 7 or more indicating that the baby is in good to excellent condition [36].