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Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18,000 children

Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18,000 children
Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18,000 children

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 diet were estimated by energy-adjusted Dietary Inflammatory Index (E-DII TM) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured by 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 FVC in children (Z-score difference (95% confidence interval (CI)): -0.05 (-0.08, -0.02), per IQR increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. When exploratively examining 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 FEV 1/FVC (z-score <-1.64) (OR (95% CI) 1.20 (1.06, 1.36), 1.40 (1.06, 1.85), compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%.

CONCLUSION: 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.

0903-1936
Mensink-Bout, Sara M.
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van Meel, Evelien R.
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de Jongste, Johan C.
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Annesi-Maesano, Isabella
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Aubert, Adrien M.
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Bernard, Jonathan Y.
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Chen, Ling-Wei
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Cooper, Cyrus
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Crozier, Sarah
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Hanke, Wojciech
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Harvey, Nicholas
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Hebert, James R.
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Heude, Barbara
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Jerzynska, Joanna
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Kelleher, Cecily
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Mehegan, John
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McAuliffe, Fionnuala M.
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Phillips, Catherine M.
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Relton, Caroline L.
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Suderman, Matthew
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Jaddoe, Vincent W. V.
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Duijts, Liesbeth
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Mensink-Bout, Sara M.
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van Meel, Evelien R.
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de Jongste, Johan C.
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Annesi-Maesano, Isabella
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Aubert, Adrien M.
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Bernard, Jonathan Y.
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Chen, Ling-Wei
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Cooper, Cyrus
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Crozier, Sarah
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Hanke, Wojciech
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Harvey, Nicholas
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Hebert, James R.
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Heude, Barbara
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Jerzynska, Joanna
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Kelleher, Cecily
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Mehegan, John
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Phillips, Catherine M.
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Polanska, Kinga
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Relton, Caroline L.
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Shivappa, Nitin
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Suderman, Matthew
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Jaddoe, Vincent W. V.
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Duijts, Liesbeth
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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, Hanke, Wojciech, Harvey, Nicholas, Hebert, James R., Heude, Barbara, Jerzynska, Joanna, Kelleher, Cecily, Mehegan, John, McAuliffe, Fionnuala M., Phillips, Catherine M., Polanska, Kinga, Relton, Caroline L., Shivappa, Nitin, Suderman, Matthew, Jaddoe, Vincent W. V. and Duijts, Liesbeth (2021) Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18,000 children. European Respiratory Journal. (doi:10.1183/13993003.01315-2021).

Record type: Article

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 diet were estimated by energy-adjusted Dietary Inflammatory Index (E-DII TM) and Dietary Approaches to Stop Hypertension (DASH) scores. Preschool wheezing and school-age asthma were measured by 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 FVC in children (Z-score difference (95% confidence interval (CI)): -0.05 (-0.08, -0.02), per IQR increase). No linear associations of the maternal E-DII or DASH score with child's wheezing or asthma were observed. When exploratively examining 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 FEV 1/FVC (z-score <-1.64) (OR (95% CI) 1.20 (1.06, 1.36), 1.40 (1.06, 1.85), compared to ≥10th percentile), with corresponding population attributable risk fractions of 1.7% and 3.3%.

CONCLUSION: 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.

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More information

Accepted/In Press date: 20 August 2021
e-pub ahead of print date: 9 September 2021
Published date: 9 September 2021

Identifiers

Local EPrints ID: 451132
URI: http://eprints.soton.ac.uk/id/eprint/451132
ISSN: 0903-1936
PURE UUID: b696a1ec-4a52-421f-b089-f53c317166ef
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

Catalogue record

Date deposited: 14 Sep 2021 10:37
Last modified: 22 Nov 2021 02:50

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Contributors

Author: Sara M. Mensink-Bout
Author: Evelien R. van Meel
Author: Johan C. de Jongste
Author: Isabella Annesi-Maesano
Author: Adrien M. Aubert
Author: Jonathan Y. Bernard
Author: Ling-Wei Chen
Author: Cyrus Cooper ORCID iD
Author: Sarah Crozier ORCID iD
Author: Wojciech Hanke
Author: Nicholas Harvey ORCID iD
Author: James R. Hebert
Author: Barbara Heude
Author: Joanna Jerzynska
Author: Cecily Kelleher
Author: John Mehegan
Author: Fionnuala M. McAuliffe
Author: Catherine M. Phillips
Author: Kinga Polanska
Author: Caroline L. Relton
Author: Nitin Shivappa
Author: Matthew Suderman
Author: Vincent W. V. Jaddoe
Author: Liesbeth Duijts

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