Maternal diet in pregnancy and child's respiratory outcomes: an individual participant data meta-analysis of 18 000 children.
Mensink-Bout SM., van Meel ER., de Jongste JC., Annesi-Maesano I., Aubert AM., Bernard JY., Chen L-W., Cooper C., Crozier SR., Hanke W., Harvey NC., Hébert JR., Heude B., Jerzynska J., Kelleher CC., Mehegan J., McAuliffe FM., Phillips CM., Polanska K., Relton CL., Shivappa N., Suderman M., Jaddoe VWV., Duijts L.
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-DIITM) 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 FEV1/FVC (z-score