Effects of prenatal artificial sweeteners consumption on birth outcomes: a systematic review and meta-analysis

Abstract

Objective: To examine the influence of prenatal artificial sweetener consumption on birth outcomes. Design: Systematic review and meta-analysis. Setting: Online databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, Scopus, Web of Science, FSTA - the food resource database, and ClinicalTrials.gov) were searched up to April 9, 2020. Studies of all designs (except case studies and reviews) were eligible, which contained information on the relevant population (pregnant women), intervention/exposure (any artificial sweeteners consumption), comparator (no artificial sweetener consumption), and birth outcomes (preterm delivery, gestational age, birth weight). Results: From 677 citations, ten cohort studies and one randomized controlled trial (n=138,007 women) were included. “Low” to “very low” certainty evidence revealed that daily consumption of artificial sweeteners was associated with an increased risk of preterm delivery (three studies, n=129,009; risk ratio=1.18, 95% CI: 1.09 to 1.28, I2=9%), a 24 g increase in birth weight (three studies, n=64,417; mean difference [MD]: 23.74 g, 95% confidence interval [CI]: 0.89 to 45.58, I2=0%), and a 0.11 week decrease in gestational age (three studies, n=64,417; MD:-0.11 weeks, 95% CI: -0.19 to -0.03, I2=0%). Conclusion: “Low” to “very low” certainty evidence suggests daily AS consumption during pregnancy is associated with an increased risk of preterm delivery, increased birth weight and decreased gestational age. Additional “high” quality research is urgently needed to further assess these relationships. PROSPERO registration number: CRD42019136728

Consumption of Non-Nutritive Sweetener during Pregnancy and Weight Gain in Offspring: Evidence from Human Studies

“…However, no systematic review on human studies of NNS for weight gain in offspring was available. Cai et al [ 30 ] conducted a meta-analysis to assess the relationship between NNS intake during pregnancy and birth weight by including three cohort studies [ 6 , 15 , 31 ]. Nevertheless, several methodological defects existed in their review.…”

Newborns from Mothers Who Intensely Consumed Sucralose during Pregnancy Are Heavier and Exhibit Markers of Metabolic Alteration and Low-Grade Systemic Inflammation: A Cross-Sectional, Prospective Study

“…Cai et al conducted a meta-analysis finding that women who consumed sucralose and other NNS during pregnancy delivered babies with an increased birth weight and a decreased gestational age compared to women reporting not to utilize NNS [ 12 ]. Moreover, the ingestion of aspartame or sucralose during gestation increased body mass index (BMI) and fat mass of children at three years, while also producing elevated body weight and adiposity in C57BL/6 mice [ 13 ].…”

Maternal Intake of Either Fructose or the Artificial Sweetener Acesulfame-K Results in Differential and Sex-Specific Alterations in Markers of Skin Inflammation and Wound Healing Responsiveness in Mouse Offspring: A Pilot Study

“…Work by Laforst-Lapointe et al showed that maternal consumption of AS during pregnancy was associated with infant gut microbiota and metabolic modifications concomitant with an increased infant body mass index [11]. A recent systematic review demonstrated that maternal exposure to AS during pregnancy is associated with an increased risk of preterm birth and increased birth weight [13]. Previous work by our group has demonstrated that exposure to Ace-K and FR results in maternal glucose intolerance and reduced pregnancy duration, as well as glucose intolerance and adipocyte hypertrophy in female but not male offspring [14][15][16].…”