Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis
Maternal nutrition during pregnancy and risk of asthma, wheeze, and atopic diseases during childhood: a systematic review and meta-analysis
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DOI：
10.1111/all.12729
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发表时间：
2015-12-01
期刊：
影响因子：
12.4
通讯作者：
Castro-Rodriguez, J. A.
中科院分区：
文献类型：
--
作者：
Beckhaus, A. A.;Garcia-Marcos, L.;Castro-Rodriguez, J. A.
背景：流行病学研究表明，怀孕期间母亲的营养与儿童时期哮喘和特应性疾病的发生有关。然而，个别研究结果是相互矛盾的。本荟萃分析的目的是严格检查妊娠期间营养摄入（饮食模式、食物组、维生素或低含量元素）与儿童哮喘、喘息或特应性疾病之间关联的现有证据。方法：纳入标准如下：(i)妊娠期饮食的系统记录；（ii）后代哮喘、喘息、湿疹或其他特应性疾病的记录。主要结局是后代在儿童期哮喘或喘息的患病率；次要结果是湿疹、过敏性鼻炎或其他特应性疾病的患病率。结果：我们发现了120个标题、摘要和引文，并纳入了32项研究（29个队列）。收集了怀孕期间维生素、低聚元素、食物组和饮食模式的数据。一项荟萃分析显示，母亲摄入较多的维生素D[比值比(OR) = 0.58, 95%可信区间(CI) = 0.38-0.88]、维生素E （OR = 0.6, 95% CI = 0.46-0.78）和锌（OR = 0.62, 95% CI = 0.40-0.97）与儿童时期发生喘息的几率较低相关。然而，这些或其他营养物质都与哮喘本身或其他特应性疾病没有一致的联系。结论：目前的证据表明，母亲摄入三种维生素或营养素（维生素D、维生素E和锌）中的每一种对儿童喘息有保护作用，但对哮喘或其他特应性疾病的影响尚无定论。
Background: Epidemiologic studies suggest a relationship between maternal nutrition during pregnancy and the occurrence of asthma and atopic conditions during childhood. However, individual study results are conflicting. The objective of this meta-analysis was to critically examine the current evidence for an association between nutrition (dietary patterns, food groups, vitamins, or oligo-elements) ingestion during pregnancy and asthma, wheeze, or atopic conditions in childhood.Methods: The inclusion criteria were as follows: (i) systematic recording of diet during the gestational period and (ii) documentation of asthma, wheezing, eczema, or other atopic disease in the offspring. The primary outcomes were prevalence of asthma or wheeze among the offspring during childhood; and secondary outcomes were prevalence of eczema, allergic rhinitis, or other atopic conditions.Results: We found 120 titles, abstracts, and citations, and 32 studies (29 cohorts) were included in this analysis. Data on vitamins, oligo-elements, food groups, and dietary patterns during pregnancy were collected. A meta-analysis revealed that higher maternal intake of vitamin D [odds ratio (OR) = 0.58, 95% confidence interval (CI) = 0.38-0.88], vitamin E (OR = 0.6, 95% CI = 0.46-0.78), and zinc (OR = 0.62, 95% CI = 0.40-0.97) was associated with lower odds of wheeze during childhood. However, none of these or other nutrients was consistently associated with asthma per se or other atopic conditions.Conclusions: Current evidence suggests a protective effect of maternal intake of each of three vitamins or nutrients (vitamin D, vitamin E, and zinc) against childhood wheeze but is inconclusive for an effect on asthma or other atopic conditions.