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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.

ResultsAfter 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 (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

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.

Digital Object Identifier (DOI)

APA Citation

Mensink-Bout, S. M., van Meel, E. R., de Jongste, J. C., Annesi-Maesano, I., Aubert, A. M., Bernard, J. Y., Chen, L.-W., Cooper, C., Crozier, S. R., Hanke, W., Harvey, N. C., Hébert, J. R., Heude, B., Jerzynska, J., Kelleher, C. C., Mehegan, J., McAuliffe, F. M., Phillips, C. M., Polanska, K., & Relton, C. L. (2021). Maternal diet in pregnancy and child’s respiratory outcomes: an individual participant data meta-analysis of 18 000 children. European Respiratory Journal, 2101315.