Background: Studies of the relation between maternal diet in pregnancy and respiratory and atopic outcomes in the offspring have focused on effects of individual nutrients and foods, rather than dietary patterns.
Objective: To determine whether dietary patterns in pregnancy are related to childhood asthma and related outcomes.
Design: In a population based birth cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), we related dietary patterns in pregnancy, previously identified using principal components analysis (‘health conscious’, ‘traditional’, ‘processed’, ‘vegetarian’, and ‘confectionery’), to: early wheezing phenotypes and eczema; wheezing, hayfever, eczema, doctor-diagnosed asthma, atopy and total IgE at 7 years; lung function and bronchial responsiveness at 8-9 years. In regression models we controlled for confounders using propensity scores.
Results: Univariately, the ‘health conscious’ pattern was positively associated with eczema, total IgE, FEV1 and FEF25-75, and negatively associated with early wheezing and asthma (unadjusted odds ratios per standard deviation (SD) increase in pattern score for early persistent wheeze and asthma, respectively: 0.78 (95% CI: 0.70 to 0.87), P=7.3x10-6, N=8886; 0.90 (95% CI: 0.84 to 0.97), P=0.007, N=7625). The ‘processed’ pattern was positively associated with early wheezing, and negatively associated with atopy and FVC. On controlling for confounders, effects were substantially attenuated and became non-significant (adjusted odds ratios for the associations of the ‘health-conscious’ pattern with early persistent wheeze and asthma, respectively: 1.00 (0.86 to 1.16), P=0.99; 0.95 (0.86 to 1.04), P=0.27).
Conclusions: In this cohort, dietary patterns in pregnancy do not predict asthma and related outcomes in the offspring after controlling for confounders.