Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18 000 children. Issue 4 (21st April 2022)

• Record Type: Journal Article
• Authors: Mensink-Bout, Sara M.; van Meel, Evelien R.; de Jongste, Johan C.; Annesi-Maesano, Isabella; Aubert, Adrien M.; Bernard, Jonathan Y.; Chen, Ling-Wei; Cooper, Cyrus; Crozier, Sarah R.; Hanke, Wojciech; Harvey, Nicholas C.; Hébert, James R.; Heude, Barbara; Jerzynska, Joanna; Kelleher, Cecily C.; Mehegan, John; McAuliffe, Fionnuala M.; Phillips, Catherine M.; Polanska, Kinga; Relton, Caroline L.; Shivappa, Nitin; Suderman, Matthew; Jaddoe, Vincent W.V.; Duijts, Liesbeth
• Is Part Of: European respiratory journal. Volume 59:Issue 4(2022)
• Publication Date: 2022-04-21
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01315-2021
• Languages: English
• ISSNs: 0903-1936

Abstract

Rationale: Severe fetal malnutrition has been related to an increased risk of respiratory diseases later in life, but evidence for the association of a suboptimal diet during pregnancy with respiratory outcomes in childhood is conflicting. We aimed to examine whether a pro-inflammatory or low-quality maternal diet during pregnancy was associated with child's respiratory health. Methods: We performed an individual participant meta-analysis among 18 326 mother–child pairs from seven European birth cohorts. Maternal pro-inflammatory and low-quality diets were estimated by energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured using questionnaires and lung function by spirometry. Results: After adjustment for lifestyle and sociodemographic factors, we observed that a higher maternal E-DII score (a more pro-inflammatory diet) during pregnancy was associated only with a lower forced vital capacity (FVC) in children (z-score difference −0.05, 95% CI −0.08– −0.02, per interquartile range increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. In an exploratory examination of the extremes, a very low DASH score (<10th percentile) (a very low dietary quality) was associated with an increased risk of preschool wheezing and a low forced expiratory volume in 1 s/FVC (z-score <−1.64) (OR 1.20, 95% CI 1.06–1.36 and z-score difference 1.40, 95% CI 1.06–1.85, compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%, respectively. Conclusion: The main results from this individual participant data meta-analysis do not support the hypothesis that maternal pro-inflammatory or low-quality diet in pregnancy are related to respiratory diseases in childhood. A suboptimal maternal diet in pregnancy, as defined by a higher inflammatory potential or low quality of the diet, does not play an important role in the development of respiratory diseases in childhood https://bit.ly/38dj3jU