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 Crozier, Wojciech Hanke, Nincholas C. Harvey, James R. Hebert, Barbara Heude, Joanna Jerzynska, Cecily C. Kelleher, John Mehegan, Fionnuala M. McAuliffe, Catherine M. Phillips, Kinga Polanska, Caroline L. ReltonNitin Shivappa, Matthew Suderman, Vincent Jaddoe, Liesbeth Duijts

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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 energyadjusted 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.

Original languageEnglish
Article number2101315
Number of pages11
JournalEuropean Respiratory Journal
Issue number4
Publication statusPublished - 1 Apr 2022


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