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

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

Journal: The European respiratory journal 2022;59(4):2101315

PMID: 34503987

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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.

Address: The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; Institute of Epidemiology and Public Health, EPAR, Sorbonne Université, Paris, France.; Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France.; Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France.; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore.; HRB Centre for Health and Diet Research, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland.; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.; MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.; Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.; Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.; Department of Nutrition Connecting Health Innovations LLC, Columbia, SC, USA.; Department of Pediatrics and Allergy, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.; UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.; MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, The Netherlands [email protected].; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.; Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.

DOI: 10.1183/13993003.01315-2021

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MeSH Terms: Asthma, Child, Preschool, Diet, Female, Forced Expiratory Volume, Humans, Pregnancy, Respiratory Sounds, Vital Capacity