Associations between maternal antioxidant intakes in pregnancy and infant allergic outcomes.

Christina E West, Janet Dunstan, Suzi McCarthy, Jessica Metcalfe, Nina D'Vaz, Suzanne Meldrum, Wendy H Oddy, Meri K Tulic, Susan L Prescott

Journal: Nutrients 2013;4(11):1747-58

PMID: 23201845

Plain Language Summary

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This research studied the maternal intake of antioxidants (carotene, vitamin C, vitamin E, copper and zinc) during pregnancy and the effect on allergic outcomes during early infancy (eczema, food allergies, allergic sensitisation and wheeze) at 1 year of age. The study included 300 mother and child pairs from a pregnancy cohort in Western Australia from 2005 to 2008. The pregnant women had a family history of allergic rhinitis, asthma, eczema, food or other allergy. A post-natal randomised trial allocated either 650mg fish oil (280mg docosahexaenoic acid (DHA) and 110mg eicosapentaenoic acid (EPA)) or a placebo of olive oil for the first 6 months of life. The study also examined the effect of maternal diet during pregnancy. Demographic information was collected, and a semi quantitative food frequency questionnaire covering 212 foods was completed during the final trimester of pregnancy. Clinical outcome measures of the infants were taken at 12 months of age via a detailed history and examination. Eczema, IgE mediated food allergies and allergic sensitisation were the most common clinical outcomes of the study. The majority of pregnant women met the recommended daily intakes of antioxidants apart from vitamin E and zinc. At 12 months of age there was no difference in the occurrence of clinical outcomes between the fish oil and placebo groups. Higher dietary vitamin C in the mothers was associated with reduced risk of any diagnosed allergic disease when children were a year old, and also a reduced risk of wheeze. Higher copper intake was related to reduced risk of wheeze and development of early allergic disease. However, this was only seen in relation to nutrients from food rather than supplements. It was noted that there were no significant associations between early allergic responses/disease and dietary intake of carotene, vitamin E and zinc. In the group studied, the majority of mothers used some vitamin/mineral supplementation during pregnancy. There was no statistically significant association between carotene, vitamin E and zinc intake in pregnancy and risk of developing any allergic disease. Women reported intakes of dietary vitamin C were above the daily recommended intake of 60mg, and authors noted that allergic outcomes were not affected by vitamin supplementation.

Abstract

Antioxidant intakes in pregnancy may influence fetal immune programming and the risk of allergic disease. We investigated associations between maternal intakes of β-carotene, vitamin C, vitamin E, copper and zinc, and infant allergic outcomes. Antioxidant intakes of pregnant women (n = 420) assessed prospectively by a food frequency questionnaire, were examined in relation to allergic outcomes at 1 year of age (n = 300). The main relationships with allergic outcomes were seen with dietary vitamin C and copper. Specifically, higher maternal dietary vitamin C intake was associated with a reduced risk of any diagnosed infant allergic disease and wheeze. After adjustment for potential confounders the relationship with wheeze remained statistically significant. There was also an inverse linear relationship between vitamin C and food allergy. Higher dietary copper intake was associated with reduced risk of eczema, wheeze and any allergic disease. The relationship with wheeze and any allergic disease remained statistically significant in multivariate analysis, and there was also an inverse linear relationship between copper and food allergy. However, these relationships were only seen for nutrients present in food. There were no relationships between β-carotene, vitamin E or zinc and any allergic outcomes. In summary, this study suggests that maternal diet of fresh foods rich in vitamin C is associated with reduced risk of infant wheeze, and that copper intake is associated with reduced risk of several allergic outcomes.

Address: School of Paediatrics and Child Health Research, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth WA 6001, Australia. [email protected]

Clinical Imbalances

Laboratory Testing

Modifiable Lifestyle Factors

Allocation Concealment

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