Literature Review: Pregnant and breastfeeding ... - Eat For Health

Reference Willers 2008Food typeDairy foods (milk and milk products)Study typeProspective cohort (longitudinal)Level of evidence II (aetiology)SettingNetherlandsFundingNetherlands Organization for Health Research and Development, Netherlands Organization for Scientific Research; Netherlands Asthma Fund;Netherlands Ministry of Spatial Planning, Housing, and the Environment; Netherlands Ministry of Health, Welfare and Sport, GlaxoSmithKlineParticipants2,832 children (part of the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort studyBaseline comparisons See confounding belowDietary assessment FFQTimingFFQ administered at antenatal recruitment (mean gestational ages not reported) to cover dietary intake over the previous monthComparisonDaily (once per day or more) consumption of milk or milk products v 1-4 times a week or fewerOutcomesWheeze, dyspnoea, prescription of inhaled steroids for respiratory problems, composite variable ‘asthma symptoms’ in the last 12 months (measuredlongitudinally from 1 to 8 years age)Results Wheeze from 1 to 8 years age (n = 2788)OR 0.84 95% CI 0.68 to 1.03aOR 0.88 95% CI 0.71 to 1.19Dyspnoea from 1 to 8 years age (n = 2788)OR 0.90 95% CI 0.71 to 1.16aOR 0.92 95% CI 0.72 to 1.19Steroid use from 1 to 8 years age (n = 2788)OR 0.99 95% CI 0.72 to 1.36aOR 1.03 95% CI 0.74 to 1.43FollowupConfoundingRisk of biasRelevanceOther commentsAsthma symptoms (composite of previous three outcomes) from 1 to 8 years age (n = 2788)OR 0.89 95% CI 0.72 to 1.10aOR 0.92 95% CI 0.74 to 1.158 yearsThe child’s dietary data on fruit, vegetables, fish, eggs, full cream milk, butter and peanut butter consumption at 2 years of age were used to check forpotential confounding by the child’s diet.Results were adjusted for by sex, maternal education, parental allergy, maternal smoking during pregnancy, smoking in the home at 8 years of age,breastfeeding, presence of older siblings, birthweight, maternal overweight 1 year after pregnancy, maternal supplement use during pregnancy, regionand study arm (intervention or natural history arm).Moderate risk of bias: Initial study population of 4,146 mothers dropped to 2,832 participants with complete data (68.3%) (pregnancy questionnaire, atleast one of the outcome time points and all confounders). Participants with complete data were more likely to have a high education level, to have dailydairy food and fruit intake during pregnancy and to have breastfed and less likely to have maternal asthma or maternal atopy, smoked duringpregnancy, be from a south western region compared with participants who did not have complete data.Dietary intakes likely to be different from Australian e.g. low fish consumption in study participantsNot clear when women assessed their diet during pregnancy;83% of pregnant women used supplements (50% used folic acid/iron)Dietary guidelines for pregnant and breastfeeding women: evidence report194