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.

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.

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.

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.

严重的胎儿营养不良与日后患呼吸道疾病的风险增加有关，但怀孕期间次优饮食与儿童期呼吸系统结局之间关系的证据是相互矛盾的。我们的目的是研究怀孕期间促炎或低质量的母亲饮食是否与孩子的呼吸系统健康有关。

我们对来自 7 个欧洲出生队列的 18 326 对母子进行了个体参与者荟萃分析。通过能量调整饮食炎症指数（E-DII）和高血压饮食方法（DASH）评分来评估母亲的促炎和低质量饮食。通过问卷调查测量学龄前喘息和学龄期哮喘，并通过肺活量测定法测量肺功能。

在调整生活方式和社会人口因素后，我们观察到，怀孕期间较高的母亲 E-DII 评分（更促炎的饮食）仅与儿童较低的用力肺活量 (FVC) 相关（z 评分差异 –0.05， 95% CI –0.08– –0.02，每四分位距增加）。未观察到母亲 E-DII 或 DASH 评分与儿童喘息或哮喘之间存在线性关联。在一项对极端情况的探索性检查中，非常低的 DASH 分数（<10%）（非常低的饮食质量）与学龄前喘息风险增加和 1 s/FVC 低用力呼气量（z 分数 < –1.64)（OR 1.20，95% CI 1.06–1.36，z 分数差异 1.40，95% CI 1.06–1.85，与≥10%相比），相应的人群归因风险分数分别为 1.7% 和 3.3%。

这项个体参与者数据荟萃分析的主要结果并不支持母亲孕期促炎症或低质量饮食与儿童期呼吸系统疾病相关的假设。