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. 2019 Dec;9(2):020405.
doi: 10.7189/jogh.09.020405.

The impact of maternal nutrition on offspring's risk of non-communicable diseases in adulthood: a systematic review

Jessie Pullar  1 , Kremlin Wickramasinghe  1 , Alessandro R Demaio  2 , Nia Roberts  3 , Karla-Maria Perez-Blanco  1 , Katharine Noonan  1 , Nick Townsend  1
Affiliations

The impact of maternal nutrition on offspring's risk of non-communicable diseases in adulthood: a systematic review

Jessie Pullar et al. J Glob Health. 2019 Dec.

Abstract

Background: A growing body of evidence suggests the impact of maternal nutrition plays a role in determining offspring's risk of non-communicable diseases (NCDs), including heart disease (CVD), type 2 diabetes (T2DM), cancer and chronic obstructive pulmonary diseases (COPD). We conducted a systematic review to investigate this relationship.

Methods: We systematically searched CINAHL, Cochrane Database of Systematic Reviews, Cochrane Register of Controlled Trials, Database of Abstracts of Reviews of Effects, MEDLINE, EMBASE, Web of Science Core Collection and Global Health for papers published before May 2016 (PROSPERO: CRD42016039244, CRD42016039247). Included studies examined the impact of maternal nutrition (diet, vitamin status and weight) on adult offspring's NCD outcomes.

Results: Of 23 501 identified citations, 20 met our inclusion criteria. Heterogeneity of papers required narrative synthesis. Included studies involved 1 939 786 participants. CVD: Four papers examined maternal exposure to famine during gestation, 3 identified a resulting increased risk of CVD in offspring. Five identified an increased risk of offspring CVD with increasing maternal weight. T2DM: Six studies investigated maternal exposure to famine during gestation; three identified an increase in offspring's T2DM risk. Three found no increased risk; two of these were in circumstances where famine states persisted beyond pregnancy. Three papers found an increased risk of T2DM in offspring with increasing maternal BMI. CANCER: Four papers investigated maternal famine exposure during pregnancy - two identified a reduced risk of cancer in male offspring, and two an increased risk in female offspring. COPD: One study found low maternal vitamin D status was associated with reduced use of asthma medication.

Conclusions: While there are indications that exposure to both famine (particularly when coupled with exposure to nutritional excess after birth) and maternal overweight during pregnancy is associated with offspring's risk of CVD, T2DM and cancer, currently there is a lack of evidence to confirm this relationship. Despite the lack of conclusive evidence, these finding hold important research and policy implications for a lifecycle approach to the prevention of NCDs.

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Conflict of interest statement

Competing interests: Kremlin Wickramasinghe and João Breda are currently staff members of the World Health Organisation. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organisation. The authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare no further competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Countries represented by included studies according to WHO region.
Figure 3
Figure 3
Number of included studies reporting outcomes related to WHO recommendations for nutrition interventions in antenatal care.
See this image and copyright information in PMC

References

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