Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium.
Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium.
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DOI：
10.1371/journal.pmed.1003491
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发表时间：
2021-01
期刊：
影响因子：
15.8
通讯作者：
Phillips CM
中科院分区：
文献类型：
--
作者：
Chen LW;Aubert AM;Shivappa N;Bernard JY;Mensink-Bout SM;Geraghty AA;Mehegan J;Suderman M;Polanska K;Hanke W;Trafalska E;Relton CL;Crozier SR;Harvey NC;Cooper C;Duijts L;Heude B;Hébert JR;McAuliffe FM;Kelleher CC;Phillips CM
不良的出生结果是儿童期发病和死亡的主要原因，并与成年后患非传染性疾病的风险较高有关。产妇围产期和产前营养，主要集中在单一的营养素或食物，已被证明会影响婴儿的出生结果。然而，关于整个饮食的证据，考虑复杂的营养和食物的相互作用是罕见的和相互矛盾的。我们的目的是阐明围孕期和产前全饮食产妇饮食炎症潜力和质量对出生结局的影响。我们协调和汇总了来自7个欧洲母亲-后代队列（队列名称，国家）中多达24，861对母亲-子女的个体参与者数据（IPD（招聘日期）：ALSPAC，英国（1991年4月1日至1992年12月31日）;法国EDEN（2003年1月27日至2006年3月6日）;荷兰，R世代（2002年4月1日至2006年1月31日）; Lifeways，爱尔兰（2001年10月2日至2003年4月4日）; REPRO_PL，波兰（2007年9月18日至2011年12月16日）;爱尔兰区域办事处（2007年1月1日至2011年1月1日）;联合王国SWS（1998年4月6日至2002年12月17日）]。在孕前（n = 2个队列）和产前（n = 7个队列）评估母体饮食。分别使用能量调整的饮食炎症指数（E-DII）和饮食方法停止高血压（DASH）指数对母体饮食炎症潜力和质量进行排名。主要结局为出生体重和出生时胎龄。不良生育结果，即，根据标准临床截断值定义低出生体重（LBW）、巨大儿、小于胎龄儿（SGA）、大于胎龄儿（LGA）、早产和早产。使用队列特异性多变量回归分析（调整混杂因素，包括母亲教育、种族、孕前体重指数（BMI）、母亲身高、产次、吸烟和饮酒）评估母亲E-DII和DASH评分与婴儿出生结局的相关性，随后进行随机效应荟萃分析。总体而言，研究母亲分娩时的平均± SD年龄为29.5 ± 4.9岁，平均BMI为23.3 ± 4.2 kg/m2。妊娠DASH评分较高（较高的饮食质量）与较高的出生体重相关[β（95%CI）= 18.5（5.7，31.3）g/1-SD更高DASH评分; P值= 0.005]和头围[0.03（0.01，0.06）cm; P值= 0.004]，出生身长较长[0.05（0.01，0.10）cm; P值= 0.010]，分娩LBW的风险较低[比值比（OR）（95%CI）= 0.89（0.82，0.95）; P值= 0.001]和SGA [0.87（0.82，0.94）; P值< 0.001]婴儿。母亲孕前E-DII评分较高（更多促炎饮食）与出生体重较低相关[β（95%CI）=-18.7（-34.8，-2.6）g/1-SD E-DII评分越高; P值= 0.023]和出生长度越短[-0.07（-0.14，-0.01）cm; P值= 0.031]，而较高的妊娠E-DII评分与较短的出生长度相关[-0.06（−0.10，−0.01）cm; P值= 0.026]和SGA风险较高[OR（95%CI）= 1.18（1.11，1.26）; P值< 0.001]。在男性中，而不是女性，婴儿母亲怀孕前E-DII较高与出生体重和头围较低，出生身长较短，SGA的风险较高（P-性别相互作用= 0.029，0.059，0.104和0.075，分别）。未观察到母亲E-DII和DASH评分与胎龄、早产和早产、巨大儿和LGA之间存在一致性关联。本研究的局限性在于自我报告的饮食数据可能会增加非差异测量误差，并且观察设计无法明确声明因果关系。在这项队列研究中，我们观察到，母亲饮食质量低，炎症可能性高，与后代出生大小较低，后代出生SGA的风险较高，在这项多中心荟萃分析中使用协调IPD。根据预先确定的标准改善总体母体饮食模式可以优化胎儿生长，并避免与不良出生结果相关的大量医疗负担。在这项队列分析中，Ling-Wei Chen及其同事探讨了母亲饮食模式与后代出生结局的关系。不利的出生结果与儿童期发病率和死亡率较高以及成年后患非传染性疾病的风险较高有关。健康和疾病的发育起源（DOHaD）理论认为，母亲围受孕期和宫内营养可以改变后代的健康轨迹。虽然个别产妇的饮食因素已被广泛研究，全饮食产妇的饮食炎症潜力和质量对出生结果的影响的证据是稀缺的和相互矛盾的。我们调查了母亲怀孕前和产前饮食质量和炎症潜力是否与5个国家的7个欧洲队列的出生结果相关，使用来自多达24，861对母婴的协调个体参与者数据。在调整混杂因素后，我们发现怀孕期间低质量和促炎症的母亲饮食与后代出生体重降低和后代出生小于胎龄儿（SGA）的风险增加显著相关。在男性而非女性中，母亲孕前能量调整饮食炎症指数（E-DII）评分较高的婴儿与出生体重和头围较低、出生身长较短和SGA风险较高相关。改善母体整体饮食质量和降低饮食炎症可能优化胎儿生长，避免与不良出生结果相关的大量医疗负担。确保提供负担得起的健康食品的政策和向育龄妇女提供信息和支助的方案努力，例如提高对产妇饮食重要性的认识以及产前和产前咨询，将有助于妇女获得更健康的饮食。
Adverse birth outcomes are major causes of morbidity and mortality during childhood and associate with a higher risk of noncommunicable diseases in adult life. Maternal periconception and antenatal nutrition, mostly focusing on single nutrients or foods, has been shown to influence infant birth outcomes. However, evidence on whole diet that considers complex nutrient and food interaction is rare and conflicting. We aim to elucidate the influence of whole-diet maternal dietary inflammatory potential and quality during periconceptional and antenatal periods on birth outcomes. We harmonized and pooled individual participant data (IPD) from up to 24,861 mother–child pairs in 7 European mother–offspring cohorts [cohort name, country (recruitment dates): ALSPAC, UK (1 April 1991 to 31 December 1992); EDEN, France (27 January 2003 to 6 March 2006); Generation R, the Netherlands (1 April 2002 to 31 January 2006); Lifeways, Ireland (2 October 2001 to 4 April 2003); REPRO_PL, Poland (18 September 2007 to 16 December 2011); ROLO, Ireland (1 January 2007 to 1 January 2011); SWS, United Kingdom (6 April 1998 to 17 December 2002)]. Maternal diets were assessed preconceptionally (n = 2 cohorts) and antenatally (n = 7 cohorts). Maternal dietary inflammatory potential and quality were ranked using the energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) index, respectively. Primary outcomes were birth weight and gestational age at birth. Adverse birth outcomes, i.e., low birth weight (LBW), macrosomia, small-for-gestational-age (SGA), large-for-gestational-age (LGA), preterm and postterm births were defined according to standard clinical cutoffs. Associations of maternal E-DII and DASH scores with infant birth outcomes were assessed using cohort-specific multivariable regression analyses (adjusted for confounders including maternal education, ethnicity, prepregnancy body mass index (BMI), maternal height, parity, cigarettes smoking, and alcohol consumption), with subsequent random-effects meta-analyses. Overall, the study mothers had a mean ± SD age of 29.5 ± 4.9 y at delivery and a mean BMI of 23.3 ± 4.2 kg/m2. Higher pregnancy DASH score (higher dietary quality) was associated with higher birth weight [β(95% CI) = 18.5(5.7, 31.3) g per 1-SD higher DASH score; P value = 0.005] and head circumference [0.03(0.01, 0.06) cm; P value = 0.004], longer birth length [0.05(0.01, 0.10) cm; P value = 0.010], and lower risk of delivering LBW [odds ratio (OR) (95% CI) = 0.89(0.82, 0.95); P value = 0.001] and SGA [0.87(0.82, 0.94); P value < 0.001] infants. Higher maternal prepregnancy E-DII score (more pro-inflammatory diet) was associated with lower birth weight [β(95% CI) = −18.7(−34.8, −2.6) g per 1-SD higher E-DII score; P value = 0.023] and shorter birth length [−0.07(−0.14, −0.01) cm; P value = 0.031], whereas higher pregnancy E-DII score was associated with a shorter birth length [−0.06(−0.10, −0.01) cm; P value = 0.026] and higher risk of SGA [OR(95% CI) = 1.18(1.11, 1.26); P value < 0.001]. In male, but not female, infants higher maternal prepregnancy E-DII was associated with lower birth weight and head circumference, shorter birth length, and higher risk of SGA (P-for-sex-interaction = 0.029, 0.059, 0.104, and 0.075, respectively). No consistent associations were observed for maternal E-DII and DASH scores with gestational age, preterm and postterm birth, or macrosomia and LGA. Limitations of this study were that self-reported dietary data might have increased nondifferential measurement error and that causality cannot be claimed definitely with observational design. In this cohort study, we observed that maternal diet that is of low quality and high inflammatory potential is associated with lower offspring birth size and higher risk of offspring being born SGA in this multicenter meta-analysis using harmonized IPD. Improving overall maternal dietary pattern based on predefined criteria may optimize fetal growth and avert substantial healthcare burden associated with adverse birth outcomes. In this cohort analysis, Ling-Wei Chen and colleagues explore associations of maternal dietary patterns with offspring birth outcomes. Adverse birth outcomes are associated with higher morbidity and mortality during childhood and a higher risk of noncommunicable diseases in adult life. The Developmental Origins of Health and Diseases (DOHaD) theory posits that maternal periconceptional and intrauterine nutrition can alter the health trajectory of the offspring. Although individual maternal dietary factors have been studied widely, evidence on the impact of whole-diet maternal dietary inflammatory potential and quality on birth outcomes is scarce and conflicting. We investigated whether maternal prepregnancy and antenatal dietary quality and inflammatory potential are associated with birth outcomes in a consortium of 7 European cohorts in 5 countries using harmonized individual participant data from up to 24,861 mother–child pairs. After adjusting for confounders, we found that a low-quality and pro-inflammatory maternal diet during pregnancy is significantly associated with lower offspring birth weight and higher risk of offspring being born small-for-gestational-age (SGA). In male, but not female, infants higher maternal prepregnancy energy-adjusted Dietary Inflammatory Index (E-DII) score was associated with lower birth weight and head circumference, shorter birth length, and higher risk of SGA. Improving overall maternal dietary quality and reducing dietary inflammatory potential may optimize fetal growth and avert substantial healthcare burden associated with adverse birth outcomes. Policies to ensure availability of affordable healthy foods and programmatic efforts to inform and support women of reproductive age, such as raising awareness of the importance of maternal diet and prenatal and antenatal counseling would help women achieve a healthier diet.
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影响因子：
3.4
作者：
Curry, A. E.;Vogel, I.;Thorsen, P.
通讯作者：
Thorsen, P.
影响因子：
13.6
作者：
Jaddoe, Vincent W. V.;Mackenbach, Johan P.;Hofman, Albert
通讯作者：
Hofman, Albert
影响因子：
4.7
作者：
Horan, M. K.;McGowan, C. A.;McAuliffe, F. M.
通讯作者：
McAuliffe, F. M.
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
9.3
作者：
Jornayvaz FR;Vollenweider P;Bochud M;Mooser V;Waeber G;Marques-Vidal P
通讯作者：
Marques-Vidal P