Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece during the COVID-19 pandemic.

INTRODUCTION: Low-level knowledge of problematic substance use during the perinatal period may lead to numerous adverse outcomes. We sought to determine maternal tobacco, alcohol and caffeine consumption during the perinatal period during the COVID-19 pandemic. METHODS: This prospective cohort study recruited women from five Greek maternity hospitals between January and May 2020. Data were collected with a structured questionnaire initially completed by postpartum women during their hospitalization and re-administered via telephone interview in the first, third and sixth month postpartum. RESULTS: The study sample consisted of 283 women. Smoking rates decreased during pregnancy (12.4%) compared to the pre-pregnancy period (32.9%, p<0.001) and during lactation (5.6%) compared to the antenatal period (p<0.001). The smoking rate increased again after breastfeeding cessation (16.9%) compared to the rate during lactation (p<0.001), but remained lower than the pre-pregnancy rate (p=0.008). Only 1.4% of the women reported breastfeeding cessation due to smoking, whereas those who smoked more during pregnancy were more likely to cease breastfeeding (OR=1.24; 95% CI: 1.05-1.48, p=0.012). Regarding alcohol consumption, it was significantly lower during pregnancy (5.7%), lactation (5.5%) and after breastfeeding cessation (5.2%) compared to the pre-pregnancy period (21.9%, p<0.001 for all correlations). Women who consumed alcohol during lactation were less likely to wean (OR=0.21; 95% CI: 0.05-0.83, p=0.027). Caffeine intake decreased during pregnancy compared to preconception period (p<0.001), while in lactating women it remained at low rates until the 3rd month of follow-up. Caffeine consumption at one month postpartum (ß=0.09; SE=0.04, p=0.045) was positively associated with longer duration of breastfeeding. CONCLUSIONS: Tobacco, alcohol and caffeine consumption decreased in the perinatal period compared to the preconception period. The pandemic may have contributed to the downtrend in smoking and alcohol consumption due to COVID-related restrictions and fear of potential illness. Nevertheless, smoking was associated with reduced duration of breastfeeding and breastfeeding cessation.

Coffee and tea consumption during pregnancy and risk of childhood acute myeloid leukemia: A Childhood Leukemia International Consortium (CLIC) study.

BACKGROUND: Dietary habits during pregnancy have been inconsistently linked to childhood acute myeloid leukemia (AML), given the putative intrauterine onset of the disease as a result of triggering events during the critical period of fetal hematopoiesis. We investigated the potential association of maternal coffee and tea consumption during pregnancy with childhood AML risk, pooling primary data from eight case-control studies participating in the Childhood Leukemia International Consortium. METHODS: Information on coffee and/or tea consumption was available for 444 cases and 1255 age- and sex-matched controls, on coffee consumption for 318 cases and 971 controls and on tea consumption for 388 cases and 932 controls. Categories for cups of daily coffee/tea consumption were created in order to explore potential dose-response associations. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression. RESULTS: Associations were found neither in the analysis on coffee or tea nor in the analysis on coffee only consumption (any versus no). A positive association with increasing coffee intake was observed (>1 cup per day; OR: 1.40, 95% CI: 1.03-1.92, increment of one cup per day; OR: 1.18, 95% CI: 1.01-1.39). No associations were observed with tea consumption. Interaction analyses showed non-significant associations between coffee/tea and smoking. Hyperdiploidy was inversely associated with tea consumption, with other cytogenetic markers having no association with coffee/tea. CONCLUSION: Given the widespread consumption of caffeinated beverages among pregnant women, our finding is of important public health relevance, suggesting adverse effects of maternal coffee consumption during pregnancy in the offspring.

Maternal use of dietary supplements during pregnancy is not associated with coeliac disease in the offspring: The Environmental Determinants of Diabetes in the Young (TEDDY) study.

Perinatal exposure to nutrients and dietary components may affect the risk for coeliac disease (CD). We investigated the association between maternal use of vitamin D, n-3 fatty acids (FA) and Fe supplements during pregnancy and risk for CD autoimmunity (CDA) and CD in the offspring. Children at increased genetic risk were prospectively followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study. CDA was defined as having persistently positive tissue transglutaminase autoantibodies (tTGA). Diagnosis of CD was either biopsy-confirmed or considered likely if having persistently elevated levels of tTGA>100 AU. Of 6627 enrolled children, 1136 developed CDA at a median 3·1 years of age (range 0·9-10) and 409 developed CD at a median 3·9 years of age (range 1·2-11). Use of supplements containing vitamin D, n-3 FA and Fe was recalled by 66, 17 and 94 % of mothers, respectively, at 3-4 months postpartum. The mean cumulative intake over the entire pregnancy was 2014 µg vitamin D (sd 2045 µg), 111 g n-3 FA (sd 303 g) and 8806 mg Fe (sd 7017 mg). After adjusting for country, child's human leucocyte antigen genotype, sex, family history of CD, any breast-feeding duration and household crowding, Cox's proportional hazard ratios did not suggest a statistically significant association between the intake of vitamin D, n-3 FA or Fe, and risk for CDA or CD. Dietary supplementation during pregnancy may help boost nutrient intake, but it is not likely to modify the risk for the disease in the offspring.

Mid-childhood fruit and vegetable consumption: The roles of early liking, early consumption, and maternal consumption.

Previous studies have shown that early liking, early consumption, and maternal consumption of fruits and vegetables (F&V) each predict children's F&V consumption, but no one has examined the independent contributions of these three correlated factors. We aim to examine the extent to which each of these 3 factors is associated with F&V consumption in mid-childhood after accounting for the other 2 in the analysis. We analyzed data from 901 mother-child dyads from Project Viva, a prospective pre-birth cohort study. Mothers reported their child's early liking and consumption of F&V at age 2 years and later consumption at mid-childhood (median age 7.7 years). They also reported their own consumption of F&V at 6 months postpartum. We used multivariable linear regression models to examine the independent associations of these 3 factors with mid-childhood consumption, adjusting for socio-demographic, pregnancy, and child confounders. At 2 years, 53% of the mothers strongly agreed that their child liked fruit and 25% strongly agreed that their child liked vegetables. F&V consumption was 2.5 (1.3) and 1.8 (1.1) times/d at age 2 y and 1.5 (1.1) and 1.3 (0.8) times/d in mid-childhood. Maternal F&V consumption was 1.4 (1.1) and 1.5 (1.0) times/d, respectively. Children's early consumption played the most predominant role. For every 1 time/d increment in children's early consumption of F&V, mid-childhood consumption was higher by 0.25 (95% confidence interval [CI]: 0.19, 0.30) times/d for fruits and 0.21 (95% CI: 0.16, 0.26) times/d for vegetables, adjusted for confounders plus the other 2 exposures. In conclusion, children's early F&V consumption has the most significant influence on children's later consumption.

Maternal fish consumption during pregnancy and BMI in children from birth up to age 14 years: the PIAMA cohort study.

PURPOSE: This study aimed to investigate the association between maternal fish consumption during pregnancy and BMI in children and the development of this association between birth and 14 years of age, taking into account relevant mother and child covariates. METHODS: The study population consisted of 3684 Dutch children born in 1996-1997 who participated in the PIAMA birth cohort study. Maternal fish consumption during pregnancy and the child's body weight and height (up to 11 times) were reported by questionnaire. Generalized estimating equations were used to investigate whether BMI of children differed according to maternal fish consumption during pregnancy. RESULTS: The crude overall association between maternal fish consumption during pregnancy and BMI in children was non-significant (P = 0.17), but differed by the child's age (P interaction = 0.03). Children of mothers who consumed fish ≥1×/week during pregnancy (n = 909) had statistically significant lower mean BMI z scores than children of mothers who never consumed fish (n = 1025) at the ages 4, 7, 8.5, and 11.5 years. Adjustment for maternal covariates (particularly pre-pregnancy BMI) attenuated the differences, which remained statistically significant at the age of 7 years only (mean difference in BMI z score: -0.14 95 % CI -0.25; -0.03). Additional adjustment for child covariates hardly affected the results. CONCLUSIONS: In a population with relatively low fish consumption, higher fish consumption by pregnant women seems rather an indicator for more healthy maternal characteristics in general than a causal factor for the lower BMI in their children.

Gluten consumption during late pregnancy and risk of celiac disease in the offspring: the TEDDY birth cohort.

BACKGROUND: Maternal diet during pregnancy has been proposed to increase the risk of autoimmune diseases. OBJECTIVE: The objective was to investigate the association between maternal consumption of gluten-containing foods during late pregnancy and subsequent risk of celiac disease in the offspring. DESIGN: Genetically susceptible children prospectively followed from birth were screened annually for tissue transglutaminase autoantibodies (tTGAs). Children testing persistently positive for tTGAs were further evaluated for celiac disease. Diagnosis of celiac disease was confirmed by intestinal biopsy or was considered likely if the mean tTGA concentration was >100 units in 2 consecutive samples. A questionnaire on the mother's diet in late pregnancy was completed by 3-4.5 mo postpartum. Mothers were divided into 3 groups based on the tertiles of their consumption of gluten-containing foods (servings/d). The association between maternal gluten-containing food consumption and the risk of celiac disease was studied by using a time-to-event analysis. RESULTS: At the time of analysis, 359 (5%) of the 6546 children developed celiac disease. Compared with the middle category of maternal gluten-containing food consumption (servings/d), low (HR: 0.87; 95% CI: 0.67, 1.13; P = 0.296) and high (HR: 0.84; 95% CI: 0.65, 1.09; P = 0.202) consumption was not associated with risk of celiac disease in the child after adjustment for country, human leukocyte antigen genotype, family history of celiac disease, maternal education, and sex of the child. Median maternal daily consumption frequency of gluten-containing foods was higher (P < 0.0001) in Finland (5.3; IQR: 3.9-6.9), Germany (4.3; IQR: 3.1-5.5), and Sweden (3.7; IQR: 2.8-4.9) than in the United States (3.4; IQR: 2.3-4.9). No significant interaction was found between country of residence and the mothers' consumption of gluten-containing foods in relation to risk of celiac disease. CONCLUSION: The frequency of gluten-containing food consumption during late pregnancy is not associated with risk of celiac disease in the offspring.